End-to-side Aortoprosthetic Anastomoses: Long-term Computed Tomography Assessment

A, Mikati; Marache, P; A, Watel; Warembourg, H; Roux, Jean-Pierre; Noblet, D.; Soots, G

doi:10.1016/s0890-5096(06)60844-3

Cited by 34 publications

(14 citation statements)

References 3 publications

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“…Discontinuity of the anastomosis causes a false PAAA that usually occurs as a result of arterial wall disruption and mechanical stress4,7,9,13-20 rather than because of graft/suture material failure 21. Aorta versus graft compliance/diameter mismatch9,10,13,14 and extreme mechanical stress (greater in end-to-side rather than end-to-end anastomoses) at the suture-line play major pathogenetic roles 4,10,19-24. Hypertension,4,25 atherosclerosis, and previous aortic endarterectomy4 are important in suture-line failure 24.…”

Section: Discussionmentioning

confidence: 99%

“…Aorta versus graft compliance/diameter mismatch9,10,13,14 and extreme mechanical stress (greater in end-to-side rather than end-to-end anastomoses) at the suture-line play major pathogenetic roles 4,10,19-24. Hypertension,4,25 atherosclerosis, and previous aortic endarterectomy4 are important in suture-line failure 24. Major peri-operative complications, technical errors, recurrent aneurysm and α 1 -antitrypsin deficiency may be associated with an early onset of pseudoaneurysm 9-11…”

Section: Discussionmentioning

confidence: 99%

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Uninfected Para-Anastomotic Aneurysms after Infrarenal Aortic Grafting

et al. 2009

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Purpose This single-institution retrospective review examines the management of uninfected para-anastomotic aneurysms of the abdominal aorta (PAAA), developed after infrarenal grafting. Materials and Methods From October 1979 to November 2005, 31 PAAA were observed in our Department. Twenty-six uninfected PAAA of degenerative etiology, including 24 false and 2 true aneurysms, were candidates for intervention and retrospectively included in our database for management and outcome evaluation. Six (23%) patients were treated as emergencies. Surgery included tube graft interposition (n = 12), new reconstruction (n = 8), and graft removal with extra-anatomic bypass (n = 3). Endovascular management (n = 3) consisted of free-flow tube endografts. Results The mortality rate among the elective and emergency cases was 5% and 66.6%, respectively ( p = 0.005). The morbidity rate in elective cases was 57.8%, whereas 75% in emergency cases ( p = 0.99). The survival rate during the follow-up was significantly higher for elective cases than for emergency cases. Conclusion Uninfected PAAA is a late complication of aortic grafting, tends to evolve silently and is difficult to diagnose. The prevalence is underestimated and increases with time since surgery. The mortality rate is higher among patients treated as an emergency than among patients who undergo elective surgery, therefore, elective treatment and aggressive management in the case of pseudoaneurysm are the keys to obtain a good outcome. Endovascular treatment could reduce mortality. Patients who undergo infrarenal aortic grafting require life-long surveillance after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Uninfected Para-Anastomotic Aneurysms after Infrarenal Aortic Grafting

et al. 2009

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“…Despite improved surgical techniques and the availability of better graft and suture materials, enhanced patient survival rates and the use of postoperative imaging of patients with aorto-iliac graft have resulted in an increase in the observed incidence of anastomotic aneurysms, varying from 0.2% to 15% (6,7). MULDER et al reported that 44% of patients with untreated anastomotic pseudoaneurysms die of rupture after a mean follow-up of 6 years and postoperative mortality rates of 7.6% have been reported (8).…”

Section: Discussionmentioning

confidence: 99%

Emergency Balloon Sealing of a Ruptured Giant Anastomotic Aneurysm of the Groin

D’Hondt

Lysebeth

Smul

et al. 2008

Acta Chirurgica Belgica

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An 85-year-old patient presented with a giant pseudo-aneurysm in the groin fifteen years after placement of an aortobifemoral graft (ABG). The pseudo-aneurysm was expanding rapidly. To prevent massive haemorrhage an inflatable balloon was inserted into the native distal aorta. The balloon was inserted via the contralateral groin. After inflation, the pseudo-aneurysm was safely excluded by the interposition of a new prosthetic segment between the left prosthetic branch of the ABG and the common femoral artery. This technique, which has been used for more than 50 years in several other indications, is an elegant method to minimise blood loss in the treatment of large pseudoaneurysms of the groin.

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“…A melhor forma de controle desta complicação é através de exames de imagem (ultra-sonografia ou angiotomografia), que devem ser realizados nos controles tardios dos pacientes submetidos a enxerto aórtico 16 . Gautier coloca que, frente ao diagnóstico de falso aneurisma envolvendo a artéria femoral, deve-se suspeitar e investigar logo a presença de falso aneurisma aórtico 6 .…”

Section: Discussionunclassified

Tratamento endoluminal de aneurismas anastomóticos na aorta abdominal: relato de dois casos

et al. 2006

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Os aneurismas anastomóticos que envolvem a anastomose proximal de reconstruções do território aorto-ilíaco são graves, e as operações convencionais para sua correção são complexas e passíveis de graves complicações. Apresentamos dois casos de aneurismas de anastomoses proximais de enxerto aorto-bifemoral que ocorreram após 15 e 18 anos, respectivamente, de evolução dos enxertos e que foram corrigidos pela técnica endoluminal. Ambos os pacientes evoluíram bem e foram submetidos a controle pela tomografia computadorizada com 12 e 6 meses de evolução, respectivamente, com exclusão do aneurisma.

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End-to-side Aortoprosthetic Anastomoses: Long-term Computed Tomography Assessment

Cited by 34 publications

References 3 publications

Uninfected Para-Anastomotic Aneurysms after Infrarenal Aortic Grafting

Uninfected Para-Anastomotic Aneurysms after Infrarenal Aortic Grafting

Emergency Balloon Sealing of a Ruptured Giant Anastomotic Aneurysm of the Groin

Tratamento endoluminal de aneurismas anastomóticos na aorta abdominal: relato de dois casos

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