Delayed Paraplegia Following Infrarenal Abdominal Aortic Endograft Placement: Case Report and Literature Review

Vascular ◽  
2004 ◽  
Vol 12 (2) ◽  
pp. 130-135 ◽  
Author(s):  
Daniel L. Fortes ◽  
B. Zane Atkins ◽  
Andy C. Chiou
Keyword(s):  
Open Repair ◽  
Spinal Cord Ischemia ◽  
Abdominal Aortic Aneurysm Repair ◽  
Careful Consideration ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
Made In

The treatment of abdominal aortic aneurysms (AAAs) has changed over the past 12 years, with increased numbers of endovascular procedures being performed. Early morbidity is decreased following endovascular abdominal aortic aneurysm repair (EVAR) compared with open repair, and long-term studies of EVAR have focused on freedom from death, rupture, and conversion to open repair. Other less commonly encountered complications of EVAR are rarely reported. For instance, spinal cord ischemia (SCI) is a devastating complication infrequently seen after open AAA repair. This report discusses a case of delayed paraplegia after EVAR and reviews the pertinent literature. The incidence of SCI after EVAR is similar to open repair, but the mechanisms may be different. Atheroembolization and occlusion of pelvic inflow appear to be the predominant etiologies for SCI after EVAR. Careful consideration of the potential for SCI should be made in elderly patients undergoing EVAR, particularly if difficult arterial anatomy is present.

scholarly journals Abdominal aortic aneurysm repair: long-term follow-up of endovascular versus open repair

2014 ◽  
Vol 2 ◽  
pp. 273-282 ◽  
Author(s):  
Gabriele Piffaretti ◽  
Giovanni Mariscalco ◽  
Francesca Riva ◽  
Federico Fontana ◽  
Gianpaolo Carrafiello ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Long-term outcomes and factors influencing late survival following elective abdominal aortic aneurysm repair: A 24-year experience

Vascular ◽  
2015 ◽  
Vol 24 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Manar Khashram ◽  
Julie S Jenkins ◽  
Jason Jenkins ◽  
Allan J Kruger ◽  
Nicholas S Boyne ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Abdominal Aortic Aneurysms ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Background Abdominal aortic aneurysms can be either treated by an open abdominal aortic aneurysm repair or an endovascular repair. Comparing clinical predictors of outcomes and those which influence survival rates in the long term is important in determining the choice of treatment offered and the decision-making process with patients. Aims To determine the influence of pre-existing clinical predictors and perioperative determinants on late survival of elective open abdominal aortic aneurysm repair and endovascular repair at a tertiary hospital. Methods Consecutive patients undergoing elective abdominal aortic aneurysm repair from 1990 to 2013 were included. Data were collected from a prospectively acquired database and death data were gathered from the Queensland state death registry. Pre-existing risks and perioperative factors were assessed independently. Kaplan–Meier and Cox regression modeling were performed. Results During the study period, 1340 abdominal aortic aneurysms were repaired electively, of which 982 were open abdominal aortic aneurysm repair. The average age was 72.4 years old and 81.7% were males. The cumulative percentage survival rates for open abdominal aortic aneurysms repair at 5, 10, 15 and 20 years were 79, 49, 31 and 22, respectively. The corresponding 5-, 10- and 15-year survival rates for endovascular repair were not significantly different at 75, 49 and 33%, respectively (P = 0.75). Predictors of reduced survival were advanced age, American Society of Anaesthesiology scores, chronic obstructive pulmonary disease, renal impairment, bifurcated grafts, peripheral vascular disease and congestive heart failure. Conclusions Open repair offers a good long-term treatment option for patients with an abdominal aortic aneurysm and in our experience there is no significant difference in late survival between open abdominal aortic aneurysms repair and endovascular repair. Consideration of the factors identified in this study that predict reduced long-term survival for open abdominal aortic aneurysms repair and endovascular repair should be considered when deciding repair of abdominal aortic aneurysm.

scholarly journals 742 Conventional Surgery vs Endovascular Abdominal Aortic Aneurysm Repair in the Management of Mycotic Abdominal Aortic Aneurysms

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Premnath ◽  
V Zaver ◽  
G Kuhan ◽  
T Rowlands ◽  
J Quarmby ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysms ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Conventional Surgery ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Abstract Introduction This study aimed to look into the short and long-term outcomes in Mycotic Abdominal Aortic Aneurysms (MAAA) managed by Conventional Surgery (CS) and Endovascular Abdominal Aortic Aneurysm Repair (EVAR) Method Data of 17 patients who underwent CS or EVAR for MAAA from 2001 to 2017 in a single centre were collected. Complications and mortality at 3 years post-procedure were also analysed. Results Mean age was 66 (54 - 82 years), 15 (88.2%) were males. Mean aortic anterior-posterior diameter was 5.8cm (2.1 – 9.0 cm). 10 patients (58.8%) presented with rupture. 6 (35%) patients demonstrated positive cultures. 4 patients (23.5%) underwent CS and 13 (76.5) had EVAR of which 4 were surgeon modified EVARs. 5 (29%) patients developed complication within 30 days. 4 patients (23.5%) developed graft infection in long term. Total mortality was 5 (29.4%) of which one patient died within 30 days and two within 3 years of procedure. Long-term mortality was found to be significantly higher in patients treated with CS compared to EVAR (p-value 0.022). Conclusions CS for MAAA has a high mortality rate compared to EVAR. EVAR might be a simple and good alternative for this critical condition in centres with adequate expertise.

scholarly journals Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

2014 ◽  
Vol 13 (4) ◽  
pp. 318-324
Author(s):  
Rodrigo Gibin Jaldin ◽  
Marcone Lima Sobreira ◽  
Regina Moura ◽  
Matheus Bertanha ◽  
Jamil Víctor de Oliveira Mariaúba ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysms ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Arterial Access ◽  
Abdominal Aortic ◽  
First Choice ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Endovascular aneurysm repair (EVAR) is already considered the first choice treatment for abdominal aortic aneurysms (AAA). Several different strategies have been used to address limitations to arterial access caused by unfavorable iliac artery anatomy. The aim of this report is to illustrate the advantages and limitations of each option and present the results of using the internal endoconduit technique and the difficulties involved.

scholarly journals PC028. A Systematic Review and Meta-Analysis of Long-term Reintervention After Endovascular Abdominal Aortic Aneurysm Repair

2019 ◽  
Vol 69 (6) ◽  
pp. e210-e212
Author(s):  
Zachary J. Wanken ◽  
Jonathon Barnes ◽  
Jesse A. Columbo ◽  
Tarun Jella ◽  
Arian Khoshgowari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Meta Analysis ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair
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