Occluding aortic endoluminal stent graft combined with extra-anatomic axillofemoral bypass as alternative management of abdominal aortic aneurysms for patients at high risk with complex anatomic features: A preliminary report

T. Le Minh, S. Motte, A. D. Hoang, J. Ferreira, J. Golzarian, P. Dehon, J. C. Cavenaile, P. Michel, S. Guyot, C. Giot, J. C. Wautrecht, J. P. Dereume

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12 Scopus citations

Abstract

Purpose: To describe an exclusion endoluminal technique for management of abdominal aortic aneurysms among high-risk patients with complex anatomic features. Method: From January 1995 to December 1996, among 143 patients with infrarenal abdominal aortic aneurysm treated by means of endograft placement, 9 (6.3%) had complex aortic or aortoiliac morphologic features. For these patients, the endograft was delivered through a femoral cutdown in an occluding aortoiliac configuration. The contralateral iliac artery was occluded with an iliac endograft. Axillofemoral by pass grafting was performed. Computed tomographic scans were obtained regularly. Results: There was 1 postoperative death of severe arrhythmia. All aneurysms were found to be affected by thrombosis on immediately postoperative computed tomographic scans, except in 1 patient with a proximal leak, which was managed successfully with angiographic embolization. The mean follow-up time was 12 months. Aortic aneurysm diameter decreased from 2 mm at 6 months (2 patients) to 6 mm at 12 months (6 patients). All axillofemoral bypass grafts are patent. Conclusions: Placement of an occluding endograft associated with axillofemoral bypass grafting is a good alternative for patients at high risk with complex anatomic features. Longer-term follow-up study is needed to evaluate this endoluminal technique.

Original languageEnglish (US)
Pages (from-to)651-656
Number of pages6
JournalJournal of vascular surgery
Volume28
Issue number4
DOIs
StatePublished - 1998

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Copyright 2017 Elsevier B.V., All rights reserved.

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