Blankensteijn, L. (Louise) (2015) Middellange termijn resultaten van de gefenestreerde ANACONDA endograft voor de behandeling van het juxta- en suprarenale aorta aneurysma. thesis, Medicine.
Full text available on request.Abstract
Objectives A new version of the ANACONDA endograft was recently introduced to the FEVAR market. FEVAR has proven to be a reliable and successful treatment for patients with more complex abdominal aortic anatomy whom are not suitable for EVAR treatment. Only little mid-term experience has been gained regarding this new device. The aim of this study was to expand the knowledge on the ANACONDA device by analyzing the Dutch cohort of patients. Secondary, the goal was to affirm the presumption that endoleak type I resolves spontaneously in ANACONDA endografts. Methods Data from all patients treated with the ANACONDA device in the Netherlands was collected in a prospectively maintained database from co-operating hospitals that was completed and analyzed retrospectively. Results Follow-up duration ranged from 0 to 38 months with a mean of 8 months. Out of 60 patients 48 (80%) were diagnosed with a juxta-renal aneurysm. The remaining 20% were short-neck aneurysms with a mean neck length of 5.91 mm. The mean aneurysm size was 63.7 mm. Five patients died of which three due to reasons unrelated to the intervention. One patient died of bowel ischemia as a result of the procedure; one suffered a hemorrhagic stroke 115 days after the procedure. At discharge 32% of all patients were diagnosed with an endoleak type II, endoleak type I occurred in 15% and 2 patients (3%) had an endoleak type III. After six months, most of these endoleaks resolved spontaneously. In 45% of the patients decrease in the aneurysm size was found, 13 (22%) did not show any changes, while in three patients (5%) the aneurysm increased in size. Conclusions The ANACONDA fenestrated device seems to be a promising graft for patients with complex abdominal aortic anatomy. First outcomes with mid term results show safe use with high clinical success en low serious complications. Though there are still a lot of questions regarding the acceptance of endoleaks of which the high appearance is still not explicable. Can endoleaks really be accepted? Will endoleaks type I indeed al spontaneously resolve? Why is the endoleak type I rate this relatively high? And is the high rate of aneurysm sac growth in the follow up related to these endoleaks? It is also unknown whether, all endoleaks will spontaneously resolve like they did in this study. Also follow-up length is still too short to judge whether or not the slightly higher amount of increase in aneurysm size is safe enough. More research is therefore recommended to observe long-term results on more patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Zeebregts, Prof. Dr. CJAM and UMC Groningen, Afdeling Vaatchirurgie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:02 |
| Last Modified: | 25 Jun 2020 11:02 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2243 |
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