Juxtarenal aortic aneurysm: endoluminal transfemoral repair? |
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Authors: | A Ferko A Krajima B Jon M Le?ko Z Vobo?il J ?i?ka P Eliás |
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Institution: | (1) Department of War Surgery, Purkyne Military Medical Academy, 50001 Hradec Králové, Czech Republic;(2) Department of Radiology, University Hospital, 50005 Hradec Králové, Czech Republic;(3) Department of Surgery, University Hospital, 50005 Hradec Králové, Czech Republic |
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Abstract: | Endoluminal transfermoral repair of an abdominal aortic aneurysm by a stent graft placement requires a segment of the nondilated
infrarenal aorta of at least 15 mm long for safe stent graft attachment. The possibility of endoluminal treatment of a juxtarenal
abdominal aortic aneurysm with partially covered spiral Z stent was assessed in experiment and in three clinical cases. In
the experiment, the noncovered spiral Z stent was placed into the abdominal aorta, across the origins of renal arteries and
mesenteric arteries, in six dogs. In the clinical cases, a partially covered stent graft was attached in 3 patients with the
juxtarenal abdominal aortic aneurysm (of the group of 12 patients with abdominal aortic aneurysm). The stent grafts were attached
with proximal uncovered parts across the origins of the renal arteries. In experiment, the renal artery occlusions or stenoses
were not observed 36 months after stent placement, and in clinic 3 patients with the juxtarenal aortic aneurysm were successfully
treated by stent graft placement. There were no signs of flow impairment into the renal arteries 14 months after stent graft
implantation. This approach can possibly expand the indications for endoluminal grafting in the treatment of juxtarenal aortic
aneurysms in patients who are at high risk for surgery. |
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Keywords: | Aneurysm Aorta Interventional procedures Arteries Grafts Prostheses Stents |
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