초록접수 현황
| 20F-058 | 구연 발표 |
Surgical Findings and Outcomes of Endotension following Endovascular Aneurysm Repair
Hyun Soo Lee, Jung Hwan Kim, Young Nam Youn, Hyun Chel Joo,
Division of Cardiovascular surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
Purpose : To investigate the intraoperative findings and outcomes in patients with endotension after endovascular aneurysm repair(EVAR).
Methods : From 2008 to 2020, 12 patients(mean age; 76.1; range 66-88) who underwent open conversion after EVAR were included in this study. Each was subjected to open repair due to progressive enlargement of the aneurysm sac after EVAR without any detectable endoleaks on computed tomography(CT) scans. During laparotomy, the integrity of previously inserted stent-graft was inspected in all the patients. The rates of early and late complications, and aneurysm-related mortality(ARM) were evaluated.
Results : The median interval between the EVAR and surgical conversion was 45.9 months(range; 17.1-46.9). 3 of 12 patients underwent emergency operations due to an aneurysmal rupture. The median aneurysm sac size, the proximal neck diameter, and the proximal neck length before EVAR were 64mm, 23.5mm, and 30.5mm, respectively. And, median values of them changed before surgery to 93.5mm(p = 0.02), 25mm(p = 0.011), and 23mm(p = 0.003), respectively. There was no detectable endoleak in eight patients during the operation. In remained four patients, undetected endoleak on preoperative CT scan was identified; Type Ia, Type Ib, Type II, and Type III, respectively. The rates of early and late procedure-related complication, and overall aneurysm-related mortality were 8.3%, respectively.
Conclusion : The possibility of any undetected endoleaks should be considered in patients with endotension. Furthermore, continuous expansion of the aneurysmal sac can lead to remodeling of the proximal neck, which can cause a delayed endoleak and an aneurysmal rupture. Therefore, surgical interventions should be timely provided to patients with endotension.
Methods : From 2008 to 2020, 12 patients(mean age; 76.1; range 66-88) who underwent open conversion after EVAR were included in this study. Each was subjected to open repair due to progressive enlargement of the aneurysm sac after EVAR without any detectable endoleaks on computed tomography(CT) scans. During laparotomy, the integrity of previously inserted stent-graft was inspected in all the patients. The rates of early and late complications, and aneurysm-related mortality(ARM) were evaluated.
Results : The median interval between the EVAR and surgical conversion was 45.9 months(range; 17.1-46.9). 3 of 12 patients underwent emergency operations due to an aneurysmal rupture. The median aneurysm sac size, the proximal neck diameter, and the proximal neck length before EVAR were 64mm, 23.5mm, and 30.5mm, respectively. And, median values of them changed before surgery to 93.5mm(p = 0.02), 25mm(p = 0.011), and 23mm(p = 0.003), respectively. There was no detectable endoleak in eight patients during the operation. In remained four patients, undetected endoleak on preoperative CT scan was identified; Type Ia, Type Ib, Type II, and Type III, respectively. The rates of early and late procedure-related complication, and overall aneurysm-related mortality were 8.3%, respectively.
Conclusion : The possibility of any undetected endoleaks should be considered in patients with endotension. Furthermore, continuous expansion of the aneurysmal sac can lead to remodeling of the proximal neck, which can cause a delayed endoleak and an aneurysmal rupture. Therefore, surgical interventions should be timely provided to patients with endotension.
첨부파일 : Tables.docx
책임저자: Hyun Chel Joo
Division of Cardiovascular surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
발표자: Hyun Soo Lee, E-mail : mr000018@yuhs.ac