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Endovascular therapy for penetrating ulcers of the infrarenal aorta
Author(s) -
Georgiadis George S.,
Trellopoulos George,
Antoniou George A.,
Georgakarakos Efstratios I.,
Nikolopoulos Evagelos S.,
Pelekas Dimitrios,
Pitta Xanthi,
Lazarides Miltos K.
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12074
Subject(s) - medicine , interquartile range , surgery , stent , complication
Background We sought to investigate the short‐ and mid‐term results of the endovascular repair of infrarenal abdominal penetrating aortic ulcers (aPAUs). Methods Patients with infrarenal aPAUs treated by endovascular means between M arch 2004 and J une 2012 were recruited. Pre‐interventional imaging included computed tomography ( CT ) or CT angiography. Endoprostheses were chosen and deployed according to standard elective endovascular aneurysm repair anatomical requirements. Endpoints included 30‐day survival, in‐hospital mortality, 1‐year PAU ‐related mortality, 1‐year all‐cause mortality, freedom from death and freedom from cumulative complication and interventions. Statistically, the Kaplan–Meier method was applied. Results Nineteen patients (18 men, median age 70 years (interquartile range, IQR = 59–75)) suffering aPAUs ( n = 29, infrarenal = 25) were detected. The median co‐morbid severity scoring was 1.0 ( IQR = 0.4–1.4). The median follow‐up period was 33 months ( IQR = 8–51.5). Furthermore, 94.7% of patients had hypertension. Fourteen patients (73.7%) had symptoms, including four of them admitted with shock from large‐contained PAU rupture. Endoluminal stent grafting was successfully delivered in all patients. In‐hospital mortality was 10.5%. Two patients required secondary interventions (10.5%). The 30‐day survival, 1‐year PAU ‐related mortality and 1‐year all‐cause mortality were 94.7%, 89.5% and 89.5%, respectively. Freedom from death and freedom from cumulative complications and interventions was 86.4% and 86.4%, 78.9% and 78.9%, and 67.9% and 71.2% at 12, 24 and 36 months, respectively. Conclusions Urgent and elective endovascular repair of aPAUs can be achieved with high technical success. The significant co‐morbid status of the treated patients is illustrated in the considerable in‐hospital mortality and underlines the advantage of such treatment over open surgical repair.