Use of proximal aortic cuffs as an adjunctive procedure during endovascular aortic aneurysm repair |
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Authors: | Biebl Matthias Hakaim Albert G Lau Luk L Oldenburg W Andrew Klocker Josef Neuhauser Beate Paz-Fumagalli Ricardo McKinney J Mark Stockland Andrew |
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Institution: | Section of Vascular Surgery, Mayo Clinic, Jacksonville, FL, USA. |
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Abstract: | The purpose of this study was to evaluate the incidence and durability of additional proximal cuffs during endovascular abdominal aortic aneurysm repair (EVAR). A retrospective review of 90 EVAR patients was conducted. Postoperative survival, proximal sealing zone-related complications, and secondary procedures were analyzed. Additional proximal cuffs were used in 11%. Their use did not affect postoperative survival (p = .58), type I endoleak rate (4.4%; p = .19), or the need for sealing zone-related secondary procedures (6.3%; p = .38) compared with patients without cuff placement but was related to a higher cumulative graft migration rate (2.2% overall p = .02). Two patients (2.5%; p = .79) underwent conversion to open surgery, both for proximal sealing zone-related complications. Application of proximal cuffs appears to be an effective intraoperative adjunctive procedure to achieve a proximal seal during EVAR, with favorable midterm results. However, the risk of late endograft migrations may be elevated in this group. |
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