ABDOMINAL AORTIC ANEURYSM WALL STRESSES AFTER ENDO VASCULAR REPAIR

摘要

The early benefits of an endovascular approach to abdominal aortic aneurysm (AAA) treatment has been reported by many authors One of the major advantages is that endovascular repair of AAA (EVAR) as opposed to traditional open surgery, is not a major abdominal surgery. EVAR has been shown to be associated with a death rate comparable to that of surgical repair. In short term follow-up, EVAR is associated with fewer complications and a more rapid recovery. On the contrary very limited data is available on long term follow-up of EVAR patients. Graft-related secondary interventions affect a consistent percentage of the treated cases. The EUROSTAR study recently reported 13% of reintervention in 15.4 months. Our surgical unit reported 20.6% across 48 months in a recent review of 242 cases. The frequence and type of reintervention, whose principal cause is endoleak or perigraft flow, requires careful consideration. The risk of aneurysm rupture after endovascular repair (EVAR) in patients with perigraft flow is uncertain. An endoleak is most commonly caused by retrograde flow from an aortic branch into the aneurysm sac (Type-II Endoleak). In the presence of a type-II endoleak disagreement exist among physicians on the measures to be adopted. In fact, no information is available on the consequences of a type-II endoleak. The objective of this study was to determine the mechanical wall stresses on an abdominal aortic aneurysm (AAA) after EVAR and in the presence of a type-II endoleak.