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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2024
vol. 19
 
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Vascular surgery
abstract:
Original paper

Low-profile versus standard-profile stent grafts in the treatment of abdominal aortic aneurysm: a case-matched study

Marek Piwowarczyk
1
,
Mateusz Rubinkiewicz
2
,
Jerzy Krzywoń
1
,
Marcin Kołodziejski
1
,
Roger M. Krzyżewski
3
,
Katarzyna Zbierska-Rubinkiewicz
1

  1. Department of Vascular Surgery, University Hospital, Jagiellonian University, Krakow, Poland
  2. 2nd Department of General Surgery, Jagiellonian University, Krakow, Poland
  3. Department of Neurosurgery and Neurotraumatology Jagiellonian University Medical College, Krakow, Poland
Videosurgery Miniinv 2024; 19 (1): 100–106
DOI: https://doi.org/10.5114/wiitm.2024.136248
Online publish date: 2024/03/11
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Introduction
Endovascular aortic repair (EVAR) is nowadays a widespread method of managing abdominal aortic aneurysm (AAA). Low-profile stent grafts (LPSGs) enable treatment of patients with complex and anatomically challenging aneurysms, and facilitate a percutaneous and thus less invasive procedure.

Aim
To assess the outcomes of EVAR with low-profile versus standard-profile stent grafts (SPSGs).

Material and methods
Thirty-one patients with abdominal aortic aneurysms (AAA) were treated by endovascular aortic repair (EVAR) using LPSGs. The control group of patients treated with SPSGs was matched with MedCalc software. The clinical records and the preoperative and follow-up computed tomography angiography of patients who underwent endovascular treatment of AAA were included in this study.

Results
Patients in the LPSG group had significantly more often low access vessel diameter (< 6 mm) compared to the SPSG group (38.7% vs. 6.7%, p = 0.003). In 1-year follow-up, there was no rupture, no infection, no conversion to open repair and no aneurysm-related death. Five secondary interventions were necessary in the SPSG group and only 1 in the LPSG group (p = 0.09). Type of stent graft was not a risk factor of perioperative complications, presence of endoleak or reintervention (p > 0.05). Risk factors for perioperative complications were COPD and conical neck (OR = 6.3, 95% CI: 1.5–25, p = 0.01 and OR = 6.2, 95% CI: 1–39.76, p = 0.04). The risk factor for endoleak was lower maximal aneurysm diameter. The risk factor for reintervention was proximal neck diameter (OR = 0.77, 95% CI: 0.–0.97, p = 0.03).

Conclusions
Our study showed that use of LPSGs is a safe and viable method for patients with narrow access vessels who are not eligible for standard-profile systems.

keywords:

stent-graft, endovascular, abdominal aortic aneurysm, low-profile
  
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