In:
Journal of Endovascular Therapy, SAGE Publications, Vol. 7, No. 3 ( 2000-06), p. 184-191
Abstract:
To evaluate the feasibility and efficacy of a newly designed stent-graft placed across the renal arteries for exclusion of abdominal aortic aneurysms (AAAs) with short or tortuous proximal necks. Methods: Among a group of AAA patients treated with endovascular grafting, 5 had tortuous proximal necks and 13 had necks 〈 20 mm (mean 13 mm). In these 18 cases, a 2-to 3-cm uncovered segment of the stent-graft was placed transrenally using a catheter inserted into the renal artery as a guide for graft margin positioning. A newly designed stent-graft was constructed from a custom-made spiral Z-stent covered with a thin-walled Dacron material; the endografts were deployed through 16-F (aortoaortic model) or 18-F sheaths (bifurcated devices). Renal function was assessed by preoperative and postoperative measurement of urea nitrogen and creatinine. Aneurysm exclusion and renal artery patency were evaluated during follow-up using spiral computed tomography and angiography. Results: The stent-grafts were correctly placed at the intended site in all 18 patients. Renal function was not affected except transiently in 1 patient who developed bilateral renal artery stenoses 24 hours after the procedure; Palmaz stents were deployed in each renal artery to reestablish satisfactory blood flow. Of the 33 renal arteries crossed by the bare stent-graft segment, all were patent over a mean 14-month follow-up (range 7–24), including the patient with Palmaz stents implanted for postprocedural renal stenosis. Complete aneurysm exclusion was maintained in 15 (83%) of 18 patients; proximal leaks persisted in 3 patients, including 2 with severely angled proximal necks. Conclusions: Transrenal placement of the uncovered leading edge of custom-made spiral Z-stent—based endografts appears feasible and clinically effective in the treatment of AAAs with short or tortuous proximal necks.
Type of Medium:
Online Resource
ISSN:
1526-6028
,
1545-1550
DOI:
10.1177/152660280000700303
Language:
English
Publisher:
SAGE Publications
Publication Date:
2000
detail.hit.zdb_id:
2006618-1
detail.hit.zdb_id:
2049858-5
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