Repair of juxtarenal para-anastomotic aortic aneurysms after previous open repair with fenestrated and branched endovascular stent grafts

Three patients with juxtarenal para-anastomotic aortic aneurysms after previous open abdominal aortic aneurysm repair were treated with custom-designed fenestrated and branched Zenith endovascular stent grafts. Six renal arteries and two superior mesenteric arteries were targeted for incorporation b...

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Bibliographic Details
Published in:Journal of vascular surgery 2005-11, Vol.42 (5), p.997-1001
Main Authors: Adam, Donald J., Berce, Michael, Hartley, David E., Anderson, John L.
Format: Article
Language:English
Subjects:
Aged
Angiography
Aortic Aneurysm, Abdominal - diagnostic imaging
Aortic Aneurysm, Abdominal - surgery
Biological and medical sciences
Blood and lymphatic vessels
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Cardiology. Vascular system
Device Removal
Diseases of the aorta
Follow-Up Studies
Humans
Male
Medical sciences
Prosthesis Design
Prosthesis Failure
Reoperation
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Stents
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tomography, X-Ray Computed
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Summary:Three patients with juxtarenal para-anastomotic aortic aneurysms after previous open abdominal aortic aneurysm repair were treated with custom-designed fenestrated and branched Zenith endovascular stent grafts. Six renal arteries and two superior mesenteric arteries were targeted for incorporation by graft fenestrations and branches. The fenestration/renal ostium interface was secured with balloon-expandable Genesis stents (n = 5) or Jostent stent grafts (n = 1). Completion angiography demonstrated no endoleaks and antegrade perfusion in all target vessels. During follow-up, one patient developed asymptomatic renal artery occlusion and underwent further endovascular intervention for type I distal endoleak. Computed tomography at 12 months demonstrated complete aneurysm exclusion in all patients with antegrade perfusion in the remaining target vessels. Fenestrated and branched endovascular stent grafts may be an acceptable alternative to conventional open repair in this group of patients.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2005.05.062