Late failure of the endovascular infrarenal aortic aneurysm solutions - diagnosis and treatment


Authors: B. Čertík 1;  V. Třeška 1;  F. Šlauf 2;  R. Šulc 1;  M. Čechura 1;  J. Moláček 1
Authors‘ workplace: Chirurgická klinika FN Plzeň-Lochotín, přednosta: Prof. MUDr. V. Třeška DrSc. 1;  Klinika zobrazovacích metod FN Plzeň-Lochotín, přednosta: Prof. MUDr. B. Kreuzberg CSc. 2
Published in: Rozhl. Chir., 2013, roč. 92, č. 8, s. 443-449.
Category: Original articles

Overview

Introduction:
Nowadays, there are two possible solutions to aneurysms of the abdominal aorta. One is an open resection, which is undoubtedly one of the major surgeries and endovascular solutions, and which represents a smaller operating load for the patient. Long-term monitoring of patients after the endovascular solutions showed late failure in 7–17% of cases. The late incidence of endoleaks and the migration of stents are explained by changing the anatomy of the aneurysm and the resulting change in the mechanical pressure on the stent graft. If these conditions cannot be solved by an endovascular procedure the situation may present a technical challenge for the vascular surgeon.

Material and methods:
Our report on the five case studies points to possible late complications of EVAR and solutions to their individual states.

Conclusions:
In the future, it should be recognized that if the endoleak is not proven it does not mean that it cannot occur over the years and massively fill the excluded aneurysm with the risk of rupture. Undoubtedly, re-operating the open patch is a challenging exercise. Nevertheless, it is possible even with the patients who were, primarily in terms of polymorbidity, indicated EVAR.

Key words:
aortic aneurysm – stentgraft – endoleak


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Surgery Orthopaedics Trauma surgery
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