The efficency of controlled proximally openable low profile stent graft on abdominal aortic aneurisms which has a challenging anatomy: Short and midterm results

ABSTRACT:PURPOSE:This research retrospectively evaluates the short and midterm effects of controlled proximally openable low profile aortic stents which are routinely appied in our institute in patients with aortic pathology.MATERIALS AND METHODS:The preoperative demographic and operational datas, the perioperative (<1month), early (1-3 months) and midterm (>3 months) follow-up datas of patients which received controlled proximally openable low profile aortic stents treatment between 09/2008 ? 06/2011 period in our institution are evaluated.RESULTS:Endovascular stent graft had been applied in 39 patients with abdominal aortic aneurisms. Fifteen of them (38.4%) had hostile vascular anatomic criteria and twenty four (61.5%) not hostile. When the tecnical success ratios and lesion exclusion ratios were evaluated the rate was 100% in patients with both difficult and easy anatomy in perioperative period (<1 month). In early period, no escape was observed except type-2 endoleaks (12.8%). The mean follow-up time for patients was 27(±8.7)months. No ruptures, or complications due to systemic or graft related causes were observed in midterm period. In midterm period, type-1 endoleak was not observed in patiendts with difficult anatomy, whereas in easy anatomy group it was observed in 8.3% of patients, making up a mean of 5.1%. In early and midterm periods, there was no statistical difference between patients with easy and difficult anatomical features (p>0.05).CONCLUSION:The proximal aortic neck, and iliac artery access are the two main factors which can impede usage of low profile aortic stents. The openable low profile aortic endovascular stents-grafts which have been recently used can highly increase the success rates in patients with difficult anatomy. In our study, the efficiencies of these stents in patients with both easy and difficult anatomy were similar, also no statistically meaningful difference were observed in postoperative follow-ups.