Endovascular treatment of high-risk surgical patients with abdominal aortic aneurysms

• Larkov R.N.
• Kolesnikov Yu.Yu.
• Vashchenko A.V.
• Sotnikov P.G.
• Vishnyakova M.V. (Jr)
• Zagarov S.S.

Abstract

In patients with severe accompanying pathology, the use of open methods of surgical treatment of abdominal aortic aneurysms is associated with high traumaticity and significant operative risk. The development of endovascular methods made it possible to implement into clinical practice a new method – endoprosthetic repair of abdominal aortic aneurysms. Presented herein is a retrospective analysis of the immediate results of endovascular prosthetic repair of abdominal aortic aneurysms in a total of 45 patients with high surgical risk, assessed according to the Classification of the American Society of Anaesthesiologists. All patients belonged to class III risk. The mean age amounted to 66.3±6.0 years (ranging from 57 to 79 years). Endoprosthetic repair was successfully performed in 43 (96%) patients. Two (4%) patients required emergency conversions to open operative intervention. There were no cases of either intraoperative or in-hospital mortality. In one patient intraoperative type IB endoleak was eliminated by means of implanting an additional limb of endograft with closure of the orifice of the internal iliac artery. Three patients in the early postoperative period were found to have type II endoleaks. Control ultrasound duplex scanning (at 2 and 6 months) showed that the endoleak persisted in 1 patient.

Conclusion. Endoprosthetic repair of abdominal aortic aneurysms in high-risk surgical patients may be regarded as a safe and effective procedure yielding good in-hospital results.

Keywords:abdominal aortic aneurysm; endovascular treatment of abdominal aortic aneurysms; endoleaks; conversion to open operation; high-risk surgical patients

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