PMID- 10087588
OWN - NLM
STAT- MEDLINE
DCOM- 19990702
LR  - 20141120
IS  - 0036-7672 (Print)
IS  - 0036-7672 (Linking)
VI  - 129
IP  - 4
DP  - 1999 Jan 30
TI  - [Endovascular treatment of the abdominal aortic aneurysm: assessment, 
      implantation technique, after-care and results].
PG  - 113-9
AB  - BACKGROUND: Endovascular treatment of abdominal aortic aneurysm (AAA) is a new 
      minimally invasive alternative to surgical repair. Patient selection, 
      perioperative management, the procedure itself and postoperative follow-up are 
      new aspects. PATIENTS: From June 1997 to June 1998, 37/70 patients (53%) with AAA 
      were treated by the endovascular method. There were 35 males and two females, 
      mean age 74 +/- 7 years, with a mean ASA class of 3.5 +/- 0.5. Graft repair was 
      performed in 33 patients, due to inappropriate aortic anatomy for the 
      endovascular technique in 24 and leaking aneurysm in 9. METHODS: Feasibility is 
      based upon computed tomography and angiography. The procedure was performed in 
      the operating room, under general, regional and local anaesthesia in 14, 3 and 20 
      patients, respectively. 36 bifurcated and one tube endoprosthesis were implanted. 
      An open access on one femoral or iliac artery and, in case of bifurcated 
      prosthesis, usually a percutaneous access (10 Fr) on the other side were 
      performed. Positioning and delivery were monitored under fluoroscopy. RESULTS: 
      All the AAA could be sealed by the endovascular technique. In one patient, an 
      iliac limb was removed surgically because of proximal misplacement, but the 
      procedure was completed by the endovascular technique. Mean operation time was 
      140 +/- 67 minutes. ICU stay was 1.4 +/- 1.6 days and patients were discharged 
      after 6.5 +/- 3.5 days. Postoperative radiological follow-up showed totally 
      sealed aneurysms in 34/37 patients (91%). In 3 patients a residual perfusion 
      originating from a lumbar artery was observed. In 7/14 patients with AAA diameter 
      > 6 cm and without residual leakage on the control CT scan, aneurysm pulsation 
      remained after endovascular treatment. There was no early or late death after 
      endovascular repair. During the follow-up period of 4 +/- 3 months patients are 
      doing well. One patient needed balloon dilatation of an iliac limb. CONCLUSIONS: 
      Endovascular treatment of AAA is a minimally invasive technique with short 
      recovery time. This technique seems to be particularly advantageous in elderly or 
      severely ill patients. Long-term controls are mandatory to identify potential 
      complications, particularly when residual perfusion or aneurysm pulsation 
      persists.
FAU - Lachat, M
AU  - Lachat M
AD  - Klinik fur Herz- und Gefasschirurgie, Universitatsspital Zurich. 
      lachat@chi.usz.ch
FAU - Pfammatter, T
AU  - Pfammatter T
FAU - Schneider, D
AU  - Schneider D
FAU - Schmidli, J
AU  - Schmidli J
FAU - Hilfiker, P
AU  - Hilfiker P
FAU - Koppensteiner, R
AU  - Koppensteiner R
FAU - Vogt, P R
AU  - Vogt PR
FAU - Turina, M
AU  - Turina M
LA  - ger
PT  - English Abstract
PT  - Journal Article
TT  - Endovaskulare Behandlung des Bauchaortenaneurysmas: Abklarung, 
      Implantationstechnik, Nachbetreuung und Resultate.
PL  - Switzerland
TA  - Schweiz Med Wochenschr
JT  - Schweizerische medizinische Wochenschrift
JID - 0404401
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnosis/*therapy
MH  - *Blood Vessel Prosthesis
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures
MH  - Postoperative Complications/therapy
MH  - Prosthesis Implantation/*instrumentation
MH  - Stents
MH  - Treatment Outcome
EDAT- 1999/03/24 00:00
MHDA- 1999/03/24 00:01
CRDT- 1999/03/24 00:00
PHST- 1999/03/24 00:00 [pubmed]
PHST- 1999/03/24 00:01 [medline]
PHST- 1999/03/24 00:00 [entrez]
PST - ppublish
SO  - Schweiz Med Wochenschr. 1999 Jan 30;129(4):113-9.