Long-term results of aortic banding for complex infrarenal neck anatomy and type I endoleak after endovascular abdominal aortic aneurysm repair

Tex Heart Inst J. 2012;39(6):799-805.

Abstract

For many patients with abdominal aortic aneurysm, unsuitable anatomy of the infrarenal aortic neck precludes endovascular aortic aneurysm repair or causes type I endoleak after the procedure. In an attempt to overcome these challenges, we retrospectively examined the usefulness of aortic banding as an adjunctive procedure to endovascular repair in 8 patients who had an abdominal aortic aneurysm with a complex infrarenal aortic neck. The procedures were performed with the patients under general anesthesia and involved making an 8-cm upper-midline laparotomy incision to expose the aneurysmal aorta. Three patients underwent aortic banding before endovascular repair; the other 5 underwent banding after the repair because of persistent type I endoleak. After banding, the abdominal aortic aneurysm was successfully excluded in all 8 patients. Long-term follow-up (mean, 38±20 mo) revealed no type I endoleak and no procedure-related complications. In patients who have an abdominal aortic aneurysm with complex infrarenal neck anatomy or a refractory type I endoleak, performing aortic banding as an adjunctive procedure to endovascular aortic repair appears to be a safe strategy with good long-term results.

Keywords: Aortic aneurysm, abdominal/complications/surgery; blood vessel prosthesis implantation/adverse effects/methods; patient selection; postoperative complications; risk factors; stents; treatment outcome; vascular surgical procedures/instrumentation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aorta, Abdominal / diagnostic imaging*
  • Aorta, Abdominal / surgery
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography
  • Blood Vessel Prosthesis*
  • Endoleak / diagnostic imaging
  • Endoleak / surgery*
  • Endovascular Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation / methods
  • Retrospective Studies
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome