Management of Endovascular Repair for Anastomotic Pseudoaneurysm after Surgical Reconstruction

DOI 23 References
  • Ikeda Osamu
    Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences
  • Ideta Ichirou
    Department of Cardiovascular Surgery, Saiseikai Kumamoto Hospital
  • Kunitomo Ryuji
    Department of Cardiovascular Surgery, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences
  • Utsunomiya Daisuke
    Department of Radiology, Saiseikai Kumamoto Hospital
  • Urata Joji
    Department of Radiology, Saiseikai Kumamoto Hospital
  • Hirayama Touitsu
    Department of Cardiovascular Surgery, Saiseikai Kumamoto Hospital
  • Kawasuji Michio
    Department of Cardiovascular Surgery, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences
  • Yamashita Yasuyuki
    Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences

Bibliographic Information

Other Title
  • 吻合部仮性動脈瘤に対するステントグラフト内挿術の経験

Search this article

Description

Background: Anastomotic pseudoaneurysm (APA) may occur as a complication after surgical reconstruction of the aorta. We evaluated the effectiveness of endovascular stent-grafting (SG) for APA.<br>Methods: Eight men with a mean age of 74 years, with 10 APAs after surgical reconstruction of the aorta and its branches underwent SG. The location of APAs included 4 in the descending aorta, 2 in the abdominal aorta, and 4 in the iliac artery. The average interval from the prosthetic graft placement was 10 years. Four patients were symptomatic. We performed coil embolization in 4 patients for prevention of type II endoleak. They were followed with computed tomography (CT) angiographic study at 1, 3, 6 months, and every 6 months after the procedure until 6 years and annually thereafter.<br>Results: SG placement was technically successful in 9 of the 10 APAs; post-procedure aortography showed complete exclusion of the APA. In these 8 APAs, CT obtained during the follow-up period (12–72 months) demonstrated complete thrombosis of the APA and patency of the stent-graft; no major complications developed. One patient suffered recurrence of the APA at the proximal descending thoracic aorta after SG placement at the distal site, but the external iliac artery was inadvertently dissected during the second SG placement and the procedure was stopped. One patient with perforation of the duodenum occurred SG infection after 1 month, so we performed surgical reconstruction.<br>Conclusion: SG exclusion of APAs is a minimally invasive and safe alternative to open surgical reconstruction.

Journal

References(23)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top