Repair of abdominal aortic aneurysms with aorto-uni-iliac stentgraft and femoro-femoral bypass

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dc.contributor.author Smit, J.G.M.
dc.contributor.author Van Marle, J.
dc.date.accessioned 2012-07-02T12:04:23Z
dc.date.available 2012-07-02T12:04:23Z
dc.date.issued 2012-05
dc.description.abstract OBJECTIVES: Endovascular repair (EVAR) is accepted as effective treatment for abdominal aortic aneurysms (AAAs) and has become the standard of care in many instances. The standard bifurcated stentgraft (BFG) is often not possible in patients with unfavourable aneurysm morphology. The aorto-uni-iliac (AUI) graft configuration with femoro-femoral bypass (FFBP) is a promising alternative which may extend the scope of EVAR for AAAs. The aim of this study was to evaluate the feasibility, efficacy and durability of AUI with FFBP. DESIGN: The results of a single institution and a single surgeon were prospectively collected from January 2002 to August 2010. All patients were followed up at 1, 3, 6 and 12 months and then annually. RESULTS: There were 33 patients (27 males) with a mean age of 71.7 years (range 46 - 84). Open surgery posed an unacceptably high risk to all patients owing to advanced age and/or American Society of Anesthesiologists (ASA) classification 3/4. Ineligibility for BFG was due to unfavourable anatomy or a combination of factors in most cases (31 patients). Two patients had anastomotic aneurysms after previous open surgery. The technical success rate was 100%. One severe intraoperative complication occurred (perforated iliac artery). Two patients (ASA 4) died within 30 days (peri-operative mortality rate 6.1%). Seven patients (21.1%) developed postoperative wound complications. Eight patients died during follow-up of non-aneurysm-related conditions. Twenty-three patients are alive, with mean follow-up of 24.4 months and a survival rate of 69.7%. Two complications occurred during long-term follow-up, namely 1 case of graft sepsis and 1 of FFBP occlusion. CONCLUSION: AUI with FFBP is a safe, effective and durable alternative in high-risk patients with AAAs where standard open repair is contraindicated and BFG repair is not possible owing to unfavourable aneurysm morphology. en_US
dc.description.uri http://www.hmpg.co.za/journaldetail.php?journalno=8 en_US
dc.identifier.citation Smit, JGM & Van Marle, J 2012, 'Repair of abdominal aortic aneurysms with aorto-uni-iliac stentgraft and femoro-femoral bypass', South African Journal of Surgery, vol. 50, no. 2, pp. 33-36. en_US
dc.identifier.issn 0038-2361 (print)
dc.identifier.issn 2078-5151 (online)
dc.identifier.uri http://hdl.handle.net/2263/19292
dc.language.iso en en_US
dc.publisher Health and Medical Publishing Group en_US
dc.rights Health and Medical Publishing Group en_US
dc.subject Abdominal aortic aneurysms (AAAs) en_US
dc.subject Aorto-uni-iliac (AUI) stentgraft en_US
dc.subject Femoro-femoral bypass (FFBP) en_US
dc.subject Endovascular repair (EVAR) en_US
dc.title Repair of abdominal aortic aneurysms with aorto-uni-iliac stentgraft and femoro-femoral bypass en_US
dc.type Article en_US


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