The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm

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@article{16d5d903cc1b404aa22df26c6304b7c2,
title = "The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm",
abstract = "Objective/Background The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. Methods This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months’ follow-up. Results In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15–72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5{\%}, 66 ± 5{\%}, and 70 ± 5{\%}, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4{\%} and 89 ± 3{\%}, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16{\%}), 12/91 (13{\%}), 34/91 (37{\%}), and 30/91 (33{\%}) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Conclusion Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to more demanding anatomies.",
keywords = "Aortic neck anatomy, EVAR, Palmaz stent, Type Ia endoleak",
author = "M. Abdulrasak and T. Resch and B. Sonesson and J. Holst and T. Kristmundsson and Dias, {N. V.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.ejvs.2016.10.004",
language = "English",
volume = "53",
pages = "69--76",
journal = "European journal of vascular and endovascular surgery",
issn = "1532-2165",
publisher = "Elsevier",
number = "1",

}