Abstract
Purpose: We aimed to evaluate the clinical efficacy and short-term clinical outcomes of Kilt technique-based endovascular aneurysm repair (EVAR) with Seal® stent-grafts for abdominal aortic aneurysms (AAAs) with hostile neck anatomy (angle CloseSPigtSPi 60°). Materials and Methods: We retrospectively evaluated the pre-EVAR and follow-up computed tomography angiography findings of 24 patients (mean age 71 ± 11 years; age range 32–87 years; mean follow-up 50 ± 12 months) with hostile neck AAAs treated between 2010 and 2015. Serial change in aneurysmal neck angle was calculated using a standardized protocol. Relationships between clinical variables and outcomes were evaluated using univariate and multivariate Cox analyses and mixed-model regression. In addition, the Kaplan–Meier method was used to assess the cumulative rates of survival, endoleak, and reintervention. Results: The primary technical success rate (success within 24 h after EVAR) was 100% (24/24). The survival rate was 96 ± 8% at 1 month, 6 months, 1 year, and 3 years, and 87 ± 18% at 5 years. Endoleaks occurred in three patients. Four reinterventions were performed in three patients; no surgical revisions were required. Causes of post-EVAR mortality included intracerebral hemorrhage at 14 days and rhabdomyolysis at 32 months. The most remarkable change after Kilt-based EVAR was an acute decrease in the neck angle, which was observed between the pre-EVAR and first follow-up visits (at 1 month) (P = 0.001). Conclusion: Kilt-based EVAR with Seal® stent-grafts for AAAs with a severely angulated neck (angle CloseSPigtSPi 60°) provided high technical success, low mortality, and low complication rates during short-term follow-up.
| Original language | English |
|---|---|
| Pages (from-to) | 554-563 |
| Number of pages | 10 |
| Journal | CardioVascular and Interventional Radiology |
| Volume | 41 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2018 Apr 1 |
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Keywords
- Abdominal aortic aneurysm
- Abdominal aortic disease
- Aortic stent-graft
- Endovascular aneurysm repair
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Clinical Outcomes of Endovascular Aneurysm Repair with the Kilt Technique for Abdominal Aortic Aneurysms with Hostile Aneurysm Neck Anatomy : A Korean Multicenter Retrospective Study. / Jeon, Yong Sun; Cho, Young Kwon; Song, Myung Gyu; Seo, Tae-Seok; Kim, Jeong Ho; Song, Soon Young; Lee, Sam Yeol.
In: CardioVascular and Interventional Radiology, Vol. 41, No. 4, 01.04.2018, p. 554-563.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical Outcomes of Endovascular Aneurysm Repair with the Kilt Technique for Abdominal Aortic Aneurysms with Hostile Aneurysm Neck Anatomy
T2 - A Korean Multicenter Retrospective Study
AU - Jeon, Yong Sun
AU - Cho, Young Kwon
AU - Song, Myung Gyu
AU - Seo, Tae-Seok
AU - Kim, Jeong Ho
AU - Song, Soon Young
AU - Lee, Sam Yeol
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Purpose: We aimed to evaluate the clinical efficacy and short-term clinical outcomes of Kilt technique-based endovascular aneurysm repair (EVAR) with Seal® stent-grafts for abdominal aortic aneurysms (AAAs) with hostile neck anatomy (angle CloseSPigtSPi 60°). Materials and Methods: We retrospectively evaluated the pre-EVAR and follow-up computed tomography angiography findings of 24 patients (mean age 71 ± 11 years; age range 32–87 years; mean follow-up 50 ± 12 months) with hostile neck AAAs treated between 2010 and 2015. Serial change in aneurysmal neck angle was calculated using a standardized protocol. Relationships between clinical variables and outcomes were evaluated using univariate and multivariate Cox analyses and mixed-model regression. In addition, the Kaplan–Meier method was used to assess the cumulative rates of survival, endoleak, and reintervention. Results: The primary technical success rate (success within 24 h after EVAR) was 100% (24/24). The survival rate was 96 ± 8% at 1 month, 6 months, 1 year, and 3 years, and 87 ± 18% at 5 years. Endoleaks occurred in three patients. Four reinterventions were performed in three patients; no surgical revisions were required. Causes of post-EVAR mortality included intracerebral hemorrhage at 14 days and rhabdomyolysis at 32 months. The most remarkable change after Kilt-based EVAR was an acute decrease in the neck angle, which was observed between the pre-EVAR and first follow-up visits (at 1 month) (P = 0.001). Conclusion: Kilt-based EVAR with Seal® stent-grafts for AAAs with a severely angulated neck (angle CloseSPigtSPi 60°) provided high technical success, low mortality, and low complication rates during short-term follow-up.
AB - Purpose: We aimed to evaluate the clinical efficacy and short-term clinical outcomes of Kilt technique-based endovascular aneurysm repair (EVAR) with Seal® stent-grafts for abdominal aortic aneurysms (AAAs) with hostile neck anatomy (angle CloseSPigtSPi 60°). Materials and Methods: We retrospectively evaluated the pre-EVAR and follow-up computed tomography angiography findings of 24 patients (mean age 71 ± 11 years; age range 32–87 years; mean follow-up 50 ± 12 months) with hostile neck AAAs treated between 2010 and 2015. Serial change in aneurysmal neck angle was calculated using a standardized protocol. Relationships between clinical variables and outcomes were evaluated using univariate and multivariate Cox analyses and mixed-model regression. In addition, the Kaplan–Meier method was used to assess the cumulative rates of survival, endoleak, and reintervention. Results: The primary technical success rate (success within 24 h after EVAR) was 100% (24/24). The survival rate was 96 ± 8% at 1 month, 6 months, 1 year, and 3 years, and 87 ± 18% at 5 years. Endoleaks occurred in three patients. Four reinterventions were performed in three patients; no surgical revisions were required. Causes of post-EVAR mortality included intracerebral hemorrhage at 14 days and rhabdomyolysis at 32 months. The most remarkable change after Kilt-based EVAR was an acute decrease in the neck angle, which was observed between the pre-EVAR and first follow-up visits (at 1 month) (P = 0.001). Conclusion: Kilt-based EVAR with Seal® stent-grafts for AAAs with a severely angulated neck (angle CloseSPigtSPi 60°) provided high technical success, low mortality, and low complication rates during short-term follow-up.
KW - Abdominal aortic aneurysm
KW - Abdominal aortic disease
KW - Aortic stent-graft
KW - Endovascular aneurysm repair
UR - http://www.scopus.com/inward/record.url?scp=85039039311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039039311&partnerID=8YFLogxK
U2 - 10.1007/s00270-017-1867-y
DO - 10.1007/s00270-017-1867-y
M3 - Article
VL - 41
SP - 554
EP - 563
JO - Cardiovascular Radiology
JF - Cardiovascular Radiology
SN - 7415-5101
IS - 4
ER -