Outcomes and Morphologic Changes After Endovascular Repair for Abdominal Aortic Aneurysms With a Severely Angulated Neck:– A Device-Specific Analysis –

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概要

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• Background: With respect to endovascular aneurysm repair (EVAR), the development of advanced techniques and devices, namely, Cook Zenith and Gore Excluder, has helped overcome device-related problems, including device migration. Deformities of abdominal aortic aneurysms (AAAs) can influence the long-term outcome of EVAR. The post-implantation behavior of stent grafts in AAAs with a severely angulated neck (SAN) was examined. Methods and Results: Among 190 AAA patients who underwent EVAR, 46 had SAN of more than 60 degrees. The post-implantation angle and adverse events were evaluated. Forty-one patients (89%) showed straightening of the neck angle immediately after the operation (early), with 2 types of subsequent (late) configuration changes — recoil and additional straightening. Among 34 Excluder patients, 29 showed immediate straightening, without additional straightening and 8 exhibited recoil. All 12 Zenith patients showed immediate straightening; 7 subsequently exhibited additional straightening, and none of them showed recoil. A difference (P=0.04) was noted between the 2 devices in the late angle changes. In all cases, no migration was observed at the proximal sites. Conclusions: The post-implantation configuration changes in stent placement in AAA patients with SAN were different for Excluder and Zenith. Appropriate device selection and proper planning of the procedure is necessary for EVAR.

• 社団法人　日本循環器学会の論文

著者

• Miyata Tetsuro

  Division Of Surgical Oncology And Vascular Surgery Department Of Surgery The University Of Tokyo

• Takayama Toshio

  Department Of Applied Chemistry Faclty Of Engineering Kanagawa University

• Shigematsu Kunihiro

  Division Of Vascular Surgery Department Of Surgery Graduate School Of Medicine The University Of Tok

• Kato Masaaki

  Department Of Cardiovascular Surgery Morinomiya Hospital

• Hoshina Katsuyuki

  Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo

• Akai Takafumi

  Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo

• Nakazawa Tatsu

  Department of Surgery, Tokyo Metropolitan Geriatric Hospital

• Okamoto Hiroyuki

  Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo

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