Clinical Outcomes of Endovascular Aneurysm Repair with the Kilt Technique for Abdominal Aortic Aneurysms with Hostile Aneurysm Neck Anatomy: A Korean Multicenter Retrospective Study
- Authors
- Jeon, Yong Sun; Cho, Young Kwon; Song, Myung Gyu; Seo, Tae-Seok; Kim, Jeong Ho; Song, Soon-Young; Lee, Sam Yeol
- Issue Date
- 4월-2018
- Publisher
- SPRINGER
- Keywords
- Abdominal aortic disease; Aortic stent-graft; Abdominal aortic aneurysm; Endovascular aneurysm repair
- Citation
- CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, v.41, no.4, pp.554 - 563
- Indexed
- SCIE
SCOPUS
- Journal Title
- CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
- Volume
- 41
- Number
- 4
- Start Page
- 554
- End Page
- 563
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/76632
- DOI
- 10.1007/s00270-017-1867-y
- ISSN
- 0174-1551
- Abstract
- We aimed to evaluate the clinical efficacy and short-term clinical outcomes of Kilt technique-based endovascular aneurysm repair (EVAR) with Seal(A (R)) stent-grafts for abdominal aortic aneurysms (AAAs) with hostile neck anatomy (angle > 60A degrees). We retrospectively evaluated the pre-EVAR and follow-up computed tomography angiography findings of 24 patients (mean age 71 +/- 11 years; age range 32-87 years; mean follow-up 50 +/- 12 months) with hostile neck AAAs treated between 2010 and 2015. Serial change in aneurysmal neck angle was calculated using a standardized protocol. Relationships between clinical variables and outcomes were evaluated using univariate and multivariate Cox analyses and mixed-model regression. In addition, the Kaplan-Meier method was used to assess the cumulative rates of survival, endoleak, and reintervention. The primary technical success rate (success within 24 h after EVAR) was 100% (24/24). The survival rate was 96 +/- 8% at 1 month, 6 months, 1 year, and 3 years, and 87 +/- 18% at 5 years. Endoleaks occurred in three patients. Four reinterventions were performed in three patients; no surgical revisions were required. Causes of post-EVAR mortality included intracerebral hemorrhage at 14 days and rhabdomyolysis at 32 months. The most remarkable change after Kilt-based EVAR was an acute decrease in the neck angle, which was observed between the pre-EVAR and first follow-up visits (at 1 month) (P = 0.001). Kilt-based EVAR with Seal(A (R)) stent-grafts for AAAs with a severely angulated neck (angle > 60A degrees) provided high technical success, low mortality, and low complication rates during short-term follow-up.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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