J Korean Med Sci.  2011 Aug;26(8):1047-1051. 10.3346/jkms.2011.26.8.1047.

Suitability of Endovascular Repair with Current Stent Grafts for Abdominal Aortic Aneurysm in Korean Patients

• Park KH
• Lim C
• Lee JH
• Yoo JS

• KMID: 1777843
• DOI: http://doi.org/10.3346/jkms.2011.26.8.1047

Abstract

Suitability rate of endovascular aneurysm repair (EVAR) and the anatomic features causing unsuitability have not been well determined in Asian patients who have abdominal aortic aneurysm (AAA). In a single Korean center, a total of 191 patients with abdominal aortic aneurysm (maximal diameter > or = 4 cm) were identified. Aortoiliac morphologic characteristics in contrast-enhanced computed tomography images were retrospectively reviewed to determine suitability for EVAR with four FDA-approved stent-grafts. AAA was considered ideally suitable for EVAR in 46.6% of patients. The most frequent causes for unsuitability were common iliac artery (CIA) aneurysm (61.8%) and excessive neck angulation (52.9%). Problems such as small and/or short neck and small access were found in minor incidences. If CIA aneurysm is dealt by overstenting with sacrifice of internal iliac artery, suitability rate can increase to 65%. Larger aneurysms were more frequently unsuitable for EVAR and had more chance of having multiple unfavorable features. In conclusion, the overall feasibility rate for EVAR in Korean patients was not different from that in Western patients. However, considering the difference in the major causes of unsuitability, more attention has to be paid to neck angulation and CIA aneurysm to provide EVAR for more Korean patients especially who have large aneurysm.

Keyword

Aortic Aneurysm; Aorta; Aortic Surgery; Endovascular Stent

MeSH Terms

Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal/*surgery
*Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation/*instrumentation
Female
Humans
Iliac Aneurysm/surgery
Iliac Artery
Male
Middle Aged
Republic of Korea
Retrospective Studies
*Stents
Tomography, Spiral Computed

Figure

• 

  Fig. 1 Maximal diameter of abdominal aortic aneurysm versus EVAR suitability. EVAR, endovascular aneurysm repair; AAA, abdominal aortic aneurysm.

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