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Endovascular Popliteal Artery Aneurysm Repair Using an “Off-Label” Abdominal Endograft Limb-Module with Nitinol-Ring Structure: A Single Centre Experience
CardioVascular and Interventional Radiology ( IF 2.8 ) Pub Date : 2023-09-27 , DOI: 10.1007/s00270-023-03541-8
H J Nagar 1 , P Bungay 1 , A Podlasek 1 , J G Pollock 1
Affiliation  

Purpose

To evaluate endovascular popliteal artery aneurysm repair using a an “off-label” abdominal endograft limb-module with nitinol-ring structure.

Materials and Methods

Retrospective observational study of 14 popliteal artery aneurysms in 12 male patients (mean age 76 years and median ASA grade 3) treated electively using the Anaconda™ endograft limb (Terumo Aortic) at a single teaching hospital. Eight limbs were treated percutaneously and 6 limbs required surgical arterial exposure. The mean popliteal artery aneurysm diameter treated was 3.6 cm (range 2.1–5.3 cm). Stent-graft diameters and lengths used were 10–15 and 60–140 mm, respectively. The median covered stented length was 218 mm (range 160–270 mm) and median duration of follow-up was 3.7 years. Outcomes assessed included technically successful aneurysm exclusion, primary patency, re-intervention and survival.

Results

All patients had successful stent-graft deployment and aneurysm exclusion, with no early complications or mortality at 30 days. Primary stent-graft patency at 1, 3 and 4 years was 93%, 75%, and 64%. By 8 years, patency had declined with 29% (2/14) stent-grafts patent. 7/14 limbs occluded; 3 underwent re-intervention (2 surgical, 1 endovascular). There were no deaths related to the procedure. Freedom from re-intervention and survival at 1/5 years was 93%/84% and 93%/67%, respectively.

Conclusion

The Anaconda™ endograft limb for endovascular popliteal artery aneurysm repair offers good mid-term patency and acceptable long-term patency up to 4 years when compared with other grafts and open surgery. It may be considered in older comorbid patients unfit for surgery and can be performed percutaneously under local anaesthesia when anatomically feasible.

Graphical Abstract



中文翻译:

使用具有镍钛合金环结构的“标签外”腹部内移植肢体模块进行血管内腘动脉瘤修复:单中心体验

目的

使用具有镍钛诺环结构的“标签外”腹部内移植肢体模块来评估血管内腘动脉动脉瘤修复。

材料和方法

对 12 名男性患者(平均年龄 76 岁,中位 ASA 3 级)的 14 例腘动脉瘤进行回顾性观察研究,这些患者在一家教学医院使用 Anaconda™ 内移植肢体 (Terumo Aortic) 进行选择性治疗。8 个肢体进行了经皮治疗,6 个肢体需要手术暴露动脉。治疗的腘动脉瘤平均直径为 3.6 厘米(范围 2.1-5.3 厘米)。使用的覆膜支架直径和长度分别为 10-15 和 60-140 毫米。覆盖支架的中位长度为 218 毫米(范围 160-270 毫米),中位随访时间为 3.7 年。评估的结果包括技术上成功的动脉瘤排除、主要通畅、再次干预和生存。

结果

所有患者均成功进行了覆膜支架部署和动脉瘤排除,没有出现早期并发症或 30 天死亡。第 1 年、第 3 年和第 4 年的初次覆膜支架通畅率分别为 93%、75% 和 64%。到了 8 年,覆膜支架专利的通畅率下降了 29% (2/14)。7/14 四肢闭塞;3 例接受了再次干预(2 例手术,1 例血管内治疗)。没有与该手术相关的死亡。免于再次干预和 1/5 年生存率分别为 93%/84% 和 93%/67%。

结论

与其他移植物和开放手术相比,用于血管内腘动脉瘤修复的 Anaconda™ 内移植肢体具有良好的中期通畅性和可接受的长达 4 年的长期通畅性。对于不适合手术的老年合并症患者,可以考虑进行该手术,并且在解剖学上可行的情况下,可以在局部麻醉下经皮进行。

图形概要

更新日期:2023-09-29
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