November 23 2011 – At the 2011 VEITH symposium, Arno von Ristow, M.D., department of vascular and endovascular surgery, Centervasc-Rio & Clinica Sorocaba, Catholic University of Rio de Janeiro, Brazil, presented some strong findings regarding the use of endovascular techniques to deal with the management of para-anastomotic aneurysms (aneurysms that can form above or below the graft at a variety of time points after open abdominal aortic aneurysm [AAA] repair). Patients who undergo open aneurysm repair are not completely cured of their disease. New aneurysms can develop proximal and distal to the graft. However, a direct surgical approach to treat these new aneurysms is particularly challenging. The development of endovascular techniques has enabled a minimally invasive approach to many of these aneurysms.
Ristow reviewed the experience of his vascular and endovascular surgery center in treating para-anastomotic aneurysms. A total of 53 were treated, with 58 percent involving the aorta and 42 percent in the iliac arteries. The operative approach was individualized and varied according to the anatomy of the aneurysms. The majority of the aortic grafts were custom made for each patient by Nano Endoluminal. All aneurysms were successfully treated and the repair has been durable up to 42 months. In hospital mortality was 3.4 percent. Because of this encouraging result, Ristow said, “Endovascular approach is the best way to deal with para-anastomotic aneurysms.”
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