Mid- and long-term results for patients with proximal palmaz stents in endovascular aneurysm repair (EVAR)

Abstract

BACKGROUND: The use of a proximal giant Palmaz stent is a well-recognized technique treating endoleaks. The aim of this study is to report follow-up data on patients who received proximal Palmaz stents in EVAR. METHODS: Retrospective review of prospectively collected computerized departmental database from July 1999 to May 2014. Pre-operative aortic anatomy analysed, and clinical and radiological follow results reviewed. RESULTS: In a cohort of 481 infrarenal EVAR patients, six (1.2%) patients received preoperative proximal Palmaz stents for Type 1a endoleaks. The mean + SEM of neck length (distance from lowest renal to beginning of aneurysm) and neck angulation, was 25.2 + 1.82 mm and 58 + 6.12° respectively. Four patients had conical neck, and one patient had reversed conical neck (defined as 20% area increase in neck area between level of renal artery and 2 cm below this). All the patients received Cook Zenith stentgrafts. No Type 1a endoleaks were seen at completion angiogram. With a median follow up period was 11 (range 2–86) months, none of the patients had type 1a endoleaks. One patient required left iliac extension at day 10 for occluded limb. Two patient have since died (24 and 59 post-operative months) from non-aneurysm related deaths. CONCLUSIONS: In our experience, Palmaz stenting was effective, but we emphasize the importance of proper patient selection, pre-EVAR planning, and diligent follow up surveillance.