Large (24–34 mm) and wide (≥35 mm) aortic necks are a contraindication to endovascular aneurysm repair (EVAR). A 63-year-old man, unfit for conventional surgery, presented a 79 mm abdominal aortic aneurysm with 36.5 mm aortic neck and a 62 mm right common iliac artery aneurysm. He was treated endovascularly with standard commercially available stent-graft using the so-called ‘funnel technique’; by placing a thoracic stent-graft inside a bifurcated device to achieve proximal sealing. The completion angiography and the 6 months follow-up with computed tomography showed no stent-graft migration, limb occlusion or endoleak. The literature review reported 179 cases of large aortic neck managed with EVAR, all cases treated with standard devices. Conversely a wide aortic neck was reported in 9; in 2 cases were employed custom-made devices and in 7 standard stent-graft. The use of EVAR with commercially available stent-grafts is feasible and it represents an option especially in non-elective setting.

Pecoraro, F., Pakeliani, D., Dinoto, E., & Bajardi, G. (2017). Endovascular treatment of large and wide aortic neck: case report and literature review. GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 65(4), 219-224 [10.1007/s11748-016-0627-2].

Endovascular treatment of large and wide aortic neck: case report and literature review

PECORARO, Felice
;
PAKELIANI, DAVID;DINOTO, Ettore;BAJARDI, Guido
2017

Abstract

Large (24–34 mm) and wide (≥35 mm) aortic necks are a contraindication to endovascular aneurysm repair (EVAR). A 63-year-old man, unfit for conventional surgery, presented a 79 mm abdominal aortic aneurysm with 36.5 mm aortic neck and a 62 mm right common iliac artery aneurysm. He was treated endovascularly with standard commercially available stent-graft using the so-called ‘funnel technique’; by placing a thoracic stent-graft inside a bifurcated device to achieve proximal sealing. The completion angiography and the 6 months follow-up with computed tomography showed no stent-graft migration, limb occlusion or endoleak. The literature review reported 179 cases of large aortic neck managed with EVAR, all cases treated with standard devices. Conversely a wide aortic neck was reported in 9; in 2 cases were employed custom-made devices and in 7 standard stent-graft. The use of EVAR with commercially available stent-grafts is feasible and it represents an option especially in non-elective setting.
Settore MED/22 - Chirurgia Vascolare
Pecoraro, F., Pakeliani, D., Dinoto, E., & Bajardi, G. (2017). Endovascular treatment of large and wide aortic neck: case report and literature review. GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 65(4), 219-224 [10.1007/s11748-016-0627-2].
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10447/233875
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