Laganà Domenico, Guzzardi Giuseppe, Petullà Maria, Martelli Massimiliano, Ierardi Anna Maria, Del Sette Bruno, Carrafiello Gian Paolo
Department of Radiology, Istituto di Radiodiagnostica, Università "Magna Grecia", Catanzaro, Italy.
Department of Radiology, Istituto Universitario di Radiodiagnostica Azienda Ospedaliero, Universitaria "Maggiore della Carità", Novara, Italy.
Ann Vasc Surg. 2017 Nov;45:213-222. doi: 10.1016/j.avsg.2017.05.040. Epub 2017 Jun 8.
The purpose of this study was to assess the effectiveness of anastomotic pseudoaneurysms (APAs) endovascular treatment following aorto-iliac-femoral surgical reconstruction.
We retrospectively evaluated 54 patients who underwent aorto-iliac-femoral bypass (72 APAs). Follow-up was performed with echo-color-Doppler and/or computed tomography angiography at 1, 3, and 6 months after the procedure and then yearly. We compared clinical success in terms of mortality between aortic APAs and nonaortic APAs (iliac-femoral-popliteal).
Immediate technical success was 100%. No periprocedural complications occurred. Six patients died during follow-up due to causes not related to APA and 5 due to sepsis at 3 months after the procedure. Thirty-day mortality was 9% overall, and we did not register any statistically significant different between aortic APA and nonaortic APA groups. During a mean follow-up of 25.5 months (range: 3-72), we registered 3 occlusions of stent-graft leg, respectively, at 3 days, 7 days, and 24 months after the procedure, 2 type I endoleaks and 1 type III endoleak. Primary clinical success rate was 87.2%, and secondary clinical success was 95.7%.
Endovascular treatment resulted as a valid alternative to open surgery and could be proposed as the treatment of choice for APAs especially in patients with a high surgical risk.
