Outcomes of endovascular intervention for infrarenal abdominal aortic aneurysm with hostile necks

Abstract

Overview: Currently, endovascular intervention of the abdominal aortic aneurysm is considered the standard treatment method. Aneurysm neck’s morphology can affect 60% of the success or failure of endovascular intervention. Many advanced techniques to treat hostile necks have gradually become popular. However, endovascular intervention of the abdominal aortic aneurysms with hostile aneurysm necks are still considered a challenge.

Objectives: Describe the characteristics of patients with infrarenal abdominal aortic aneurysms with hostile necks. Evaluate the perioperative and mid-term outcomes of endovascular intervention to treat infrarenal abdominal aortic aneurysms with hostile necks.

Methods: The patients were diagnosed with infrarenal abdominal aortic aneurysms at the Vascular Surgery Department of Cho Ray Hospital, and were treated by endovascular intervention, from January 2020 to August 2023, and met the including criteria.

Results: The technical success rate was 95.12%. The early death rate was 2.44%. There were no aneurysm-related deaths. Early endoleak rate was low at 4.88%. Late type I endoleak was 7.5%. The mid-term mortality rate was 9.76%. The mid-term mortality rate recorded in the aneurysm necks length ≤ 15mm group was significantly higher than the other group. Late type I endoleak had no significant difference, when comparing the short neck groups and the angulated neck groups.

Conclusion: Endovascular intervention to treat infrarenal abdominal aortic aneurysms with hostile necks is a safe and effective method.