Early Australasian experience with branched endovascular thoracoabdominal aortic aneurysm repair

Russell W. Jamieson, Ravi L. Huilgol*

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: Endovascular technology can now support total endovascular thoracoabdominal aortic aneurysm repair with branches maintaining visceral and renal perfusion thus avoiding the need for massive open surgery. High-volume centres have reported encouraging results. We report our Australasian experience of 10 cases including the first-in-man 'off-the-shelf' graft. Methods: Ten consecutive endovascular repairs performed with prospective data collection have been retrospectively analysed. Results: Six men and four women with an average age of 72.4 years (range 55-85) were treated between 2009 and 2012. The mean aneurysm diameter was 7cm (range 4.8-10.0) with aneurysms across all five Crawford classifications. One hundred percent procedural technical success was achieved and all branches and fenestrations were patent at a median follow up of 12 months. In total, 30 branches were utilized together with seven fenestrations. One death from respiratory failure occurred on day 30 without endograft problems and there were two late aneurysm related deaths. Three patients experienced spinal cord ischaemia and one patient experienced two separate late endoleaks. Six patients had successful endografts and remain alive and well. Discussion: For experienced endovascular surgeons working with a proctor 100% technical success in graft deployment is achievable. Endovascular skills alone do not guarantee long-term success; our results demonstrate the need for careful patient selection, the danger of spinal cord ischaemia and the potential for endoleaks.

Original languageEnglish
Pages (from-to)808-813
Number of pages6
JournalANZ Journal of Surgery
Volume83
Issue number11
DOIs
Publication statusPublished - Nov 2013
Externally publishedYes

Keywords

  • Aortic aneurysm
  • Endovascular
  • Fenestrated
  • Thoracoabdominal
  • Vascular surgery

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