Stellenwert der endovaskulären Therapie bei Reeingriffen nach Ausschaltung aortoiliakaler Aneurysmata
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Stellenwert der endovaskulären Therapie bei Reeingriffen nach Ausschaltung aortoiliakaler Aneurysmata. / Tsilimparis, N; Laipple, A; Yousefi, S; Alevizakos, P; Spring, B Im; Rogalla, P; Hagemann, J; Hanack, U; Rückert, R I.
In: ZBL CHIR, Vol. 134, No. 4, 08.2009, p. 331-337.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Stellenwert der endovaskulären Therapie bei Reeingriffen nach Ausschaltung aortoiliakaler Aneurysmata
AU - Tsilimparis, N
AU - Laipple, A
AU - Yousefi, S
AU - Alevizakos, P
AU - Spring, B Im
AU - Rogalla, P
AU - Hagemann, J
AU - Hanack, U
AU - Rückert, R I
N1 - Georg Thieme Verlag Stuttgart.New York.
PY - 2009/8
Y1 - 2009/8
N2 - INTRODUCTION: Redo surgery or reintervention following conventional or endovascular aortoiliac reconstruction often requires exclusion of new aneurysms. In the present study the potentials of endovascular management of such lesions are investigated.METHODS: All patients with endovascular reoperation for of newly developed aortoiliac aneurysms were identified from a prospectively run data-base. The indications and results of endovascular therapy were analysed retrospectively. In detail, data were analysed for the type of original operation, interval until and kind of reoperation, and results concerning survival, technical success and complications.RESULTS: From 12 / 2003 through 3 / 2007 195 patients with aortoiliac aneurysms were operated. Endovascular repair was performed in 15 cases of previously excluded aneurysms. Mean age of these 15 patients (12 men) was 73 (64-85) years. Ten patients had a primary conventional (group A) and 5 patients had a primary endovascular (group B) aneurysm repair. The mean time interval between the first and second operation was 8.9 (1-26) years. The secondary endovascular therapy in group A was successful in all cases. In group B endoleaks type I a (n = 1), I a / b (n = 1), II (n = 2) and III (n = 1) were treated. One type II endoleak could only be treated successfully by conversion to open repair, the other one was successfully treated by reintervention. All but one patient are alive and -remained free of pathological findings during a median follow-up of 13 (2-39) months.DISCUSSION: Because of the clearly elevated operation risk of redo surgery after conventional or endovascular aneurysm repair, endovascular aneurysm exclusion represents the method of first choice. The reasonable selection and combination of procedures allows for an optimal adaptation of therapy to the individual case.
AB - INTRODUCTION: Redo surgery or reintervention following conventional or endovascular aortoiliac reconstruction often requires exclusion of new aneurysms. In the present study the potentials of endovascular management of such lesions are investigated.METHODS: All patients with endovascular reoperation for of newly developed aortoiliac aneurysms were identified from a prospectively run data-base. The indications and results of endovascular therapy were analysed retrospectively. In detail, data were analysed for the type of original operation, interval until and kind of reoperation, and results concerning survival, technical success and complications.RESULTS: From 12 / 2003 through 3 / 2007 195 patients with aortoiliac aneurysms were operated. Endovascular repair was performed in 15 cases of previously excluded aneurysms. Mean age of these 15 patients (12 men) was 73 (64-85) years. Ten patients had a primary conventional (group A) and 5 patients had a primary endovascular (group B) aneurysm repair. The mean time interval between the first and second operation was 8.9 (1-26) years. The secondary endovascular therapy in group A was successful in all cases. In group B endoleaks type I a (n = 1), I a / b (n = 1), II (n = 2) and III (n = 1) were treated. One type II endoleak could only be treated successfully by conversion to open repair, the other one was successfully treated by reintervention. All but one patient are alive and -remained free of pathological findings during a median follow-up of 13 (2-39) months.DISCUSSION: Because of the clearly elevated operation risk of redo surgery after conventional or endovascular aneurysm repair, endovascular aneurysm exclusion represents the method of first choice. The reasonable selection and combination of procedures allows for an optimal adaptation of therapy to the individual case.
KW - Aged
KW - Aged, 80 and over
KW - Angiography, Digital Subtraction
KW - Angioplasty/methods
KW - Aortic Aneurysm, Abdominal/diagnosis
KW - Aortic Rupture/diagnosis
KW - Aortography
KW - Blood Vessel Prosthesis
KW - Female
KW - Follow-Up Studies
KW - Graft Occlusion, Vascular/diagnosis
KW - Humans
KW - Iliac Artery
KW - Male
KW - Middle Aged
KW - Postoperative Complications/diagnosis
KW - Prospective Studies
KW - Prosthesis Design
KW - Recurrence
KW - Reoperation
KW - Stents
KW - Tomography, X-Ray Computed
KW - Ultrasonography, Doppler, Color
U2 - 10.1055/s-0028-1098771
DO - 10.1055/s-0028-1098771
M3 - SCORING: Zeitschriftenaufsatz
C2 - 19688682
VL - 134
SP - 331
EP - 337
JO - ZBL CHIR
JF - ZBL CHIR
SN - 0044-409X
IS - 4
ER -
