The Study On The Therapeutic Effect Of Endovascular Repair For Infrarenal Abdominal Aortic Aneurysm And How To Prevent And Cure The Complications

Background:AAA is very common in the vascular surgery. The expansion of abdominal aorta causes this disease. Abdominal aortic aneurysms (AAAs) occur in about5%of men aged over50years. The incidence appears to be increasing as the result of the increasing age.95%of these AAA are Infrarenal abdominal aortic aneurysms, some of them with iliacaneurysm. The result of untreated AAA is rupture.There are two kinds of clinical treatments for abdominal aortic aneurysm:open surgical repair(OSR) and endovascular aneurysm repair(EVAR). For patients with co-morbidities, to have an operation is more dangerous. How to handle this puzzle is becoming more and more important for vascular surgeons. EVAR is more beneficial for these patients. However, only patients with suitable anatomic conditions can receive this kind of surgery, otherwise many complications will appear. What should be considered of firstly for vascular surgeons is the causes of the complications, especially the endoleak. The prevention and treatment of complications are also very important.Object:1. To evaluate the therapeutic effects of endovascular aneurysm repair and open surgical repair for patients with infrarenal abdominal aortic aneurysms.2. To investigate the indications, procedures, prevention and treatment of complications, especially for endoleak, by summarizing our experience of endovascular aneurysm repair. Methods:The clinical data of59patients with infrarenal abdominal aortic aneurysm from January2006to October2011in Qilu Hospital of Shandong University and Laiwu-Steel Company Hospital are analyzed retrospectively.According to the surgery, patients are classified into two groups. We compared the differences between these two groups in perioperative and short-term advantages and disadvantages, such as preoperative general condition, postoperative mortality.According to summarizing our experience of endovascular repair (EVR) for abdominal aortic aneurysm (AAA), indications, procedures, prevention and treatment of complications were investigated.Results:By the comparison, patients who underwent EVAR had significant reductions in blood loss, operative time, ICU time, postoperative hospital stay, postoperative mortality.Because of anatomical conditions, there are unique complications for patients undergoing EVAR. One of these complications is endoleak. Endoleak occured in15cases. Most of them can be cured via balloon dilatation or endoluminal graft implantation.Conclusions:Endovascular aneurysm repair is more beneficial for infrarenal abdominal aortic aneurysm (IAAA) patients, especially for patients who is too weak for OSR.Short-term advantages are apparent. However, some concern has been expressed regarding technical failure and the durability of endovascular grafts.Complications related to stent can not be avoided completely because of anatomic condition, the quality of invascular stent and surgical skill. For patients with other comorbidities, it is more suitable to receive endovascular aneurysm repair than open surgical repair.