Use of the AFX Stent Graft in Patients with Extremely Narrow Aortic Bifurcation: A Multicenter Retrospective Study.

IF 2.5 Q2 PERIPHERAL VASCULAR DISEASE
International Journal of Vascular Medicine Pub Date : 2021-10-04 eCollection Date: 2021-01-01 DOI:10.1155/2021/7439173
M U Wagenhäuser, N Floros, E Nikitina, J Mulorz, K M Balzer, S Goulas, M Petrich, P Dueppers, F Simon, H Schelzig, A Oberhuber
{"title":"Use of the AFX Stent Graft in Patients with Extremely Narrow Aortic Bifurcation: A Multicenter Retrospective Study.","authors":"M U Wagenhäuser,&nbsp;N Floros,&nbsp;E Nikitina,&nbsp;J Mulorz,&nbsp;K M Balzer,&nbsp;S Goulas,&nbsp;M Petrich,&nbsp;P Dueppers,&nbsp;F Simon,&nbsp;H Schelzig,&nbsp;A Oberhuber","doi":"10.1155/2021/7439173","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study analyzed the patient outcomes following endovascular aortic aneurysm repair (EVAR) for infrarenal aortic pathologies with very narrow aortic bifurcations using the AFX stent graft.</p><p><strong>Methods: </strong>The data was retrieved from the archived medical records of 35 patients treated for abdominal aortic aneurysm (AAA) (48.6%) or penetrating aortic ulcer (PAU) (51.4%) with very narrow aortic bifurcation between January 2013 and May 2020. Patient survival, freedom from endoleak (EL), and limb occlusion were estimated applying the Kaplan-Meier method.</p><p><strong>Results: </strong>The mean follow-up time was 20.4 ± 22.8 months. The mean aortic bifurcation diameter was 15.8 ± 2.2 mm. Technical success was 100%, and no procedure-related deaths occurred. Two type II ELs occurred within 30-day follow-up. We observed one common iliac artery stenosis at four months and one type III EL at 54 months in the same patient, both of which required re-intervention. Overall patient survival was 95 ± 5% (AAA: 100%; PAU: 89 ± 10%), freedom from limb occlusion was 94 ± 5% (AAA: 91 ± 9%; PAU: 100%), freedom from type II EL was 94 ± 4% (AAA: 88 ± 8%; PAU: 100%), and freedom from EL type III was 83 ± 15% (AAA: 80 ± 18%; PAU: 100%) at the end of the follow-up period.</p><p><strong>Conclusions: </strong>Very narrow aortic bifurcations may predispose patients to procedure-related complications following EVAR. Our results suggest a safe use of the AFX stent graft in such scenarios. The overall short- and long-term procedure-related patient outcomes are satisfying albeit they may seem superior for PAU when compared to AAA.</p>","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505088/pdf/","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Vascular Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2021/7439173","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 2

Abstract

Introduction: This study analyzed the patient outcomes following endovascular aortic aneurysm repair (EVAR) for infrarenal aortic pathologies with very narrow aortic bifurcations using the AFX stent graft.

Methods: The data was retrieved from the archived medical records of 35 patients treated for abdominal aortic aneurysm (AAA) (48.6%) or penetrating aortic ulcer (PAU) (51.4%) with very narrow aortic bifurcation between January 2013 and May 2020. Patient survival, freedom from endoleak (EL), and limb occlusion were estimated applying the Kaplan-Meier method.

Results: The mean follow-up time was 20.4 ± 22.8 months. The mean aortic bifurcation diameter was 15.8 ± 2.2 mm. Technical success was 100%, and no procedure-related deaths occurred. Two type II ELs occurred within 30-day follow-up. We observed one common iliac artery stenosis at four months and one type III EL at 54 months in the same patient, both of which required re-intervention. Overall patient survival was 95 ± 5% (AAA: 100%; PAU: 89 ± 10%), freedom from limb occlusion was 94 ± 5% (AAA: 91 ± 9%; PAU: 100%), freedom from type II EL was 94 ± 4% (AAA: 88 ± 8%; PAU: 100%), and freedom from EL type III was 83 ± 15% (AAA: 80 ± 18%; PAU: 100%) at the end of the follow-up period.

Conclusions: Very narrow aortic bifurcations may predispose patients to procedure-related complications following EVAR. Our results suggest a safe use of the AFX stent graft in such scenarios. The overall short- and long-term procedure-related patient outcomes are satisfying albeit they may seem superior for PAU when compared to AAA.

AFX支架在极窄主动脉分叉患者中的应用:一项多中心回顾性研究
简介:本研究分析了使用AFX支架对非常狭窄的肾下主动脉病变进行血管内动脉瘤修复(EVAR)后的患者预后。方法:收集2013年1月至2020年5月收治的35例腹主动脉瘤(AAA)(48.6%)或穿透性主动脉溃疡(PAU)(51.4%)患者的病历资料,其中主动脉分叉极窄。应用Kaplan-Meier方法估计患者的生存、无内皮渗漏(EL)和肢体闭塞。结果:平均随访时间为20.4±22.8个月。平均主动脉分叉直径15.8±2.2 mm。技术成功率为100%,无手术相关死亡发生。随访30天内发生2例II型el。在同一例患者中,我们在4个月时观察到1例常见髂动脉狭窄,在54个月时观察到1例III型EL,两者都需要再次干预。患者总生存率为95±5% (AAA: 100%;PAU: 89±10%),肢体无闭塞性94±5% (AAA: 91±9%;PAU: 100%), II型EL的自由度为94±4% (AAA: 88±8%;PAU: 100%), III型EL自由度为83±15% (AAA: 80±18%;PAU: 100%)在随访期结束时。结论:非常窄的主动脉分叉可能使患者在EVAR后易发生手术相关并发症。我们的结果表明在这种情况下使用AFX支架是安全的。尽管与AAA相比,PAU的总体短期和长期手术相关的患者结果似乎更令人满意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
International Journal of Vascular Medicine
International Journal of Vascular Medicine PERIPHERAL VASCULAR DISEASE-
CiteScore
3.50
自引率
0.00%
发文量
7
审稿时长
16 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信