Korean Circ J.  2007 Oct;37(10):459-463. 10.4070/kcj.2007.37.10.459.

Endovascular Abdominal Aortic Aneurysmal Repair:A Korean Perspective

• Ahn CM
• Choi D
• Shim WH

• KMID: 2227045
• DOI: http://doi.org/10.4070/kcj.2007.37.10.459

Abstract

Endovascular aneurysm repair (EVAR) was initially introduced as a less invasive alternative to conventional open repair. EVAR was subsequently adopted as a treatment option for abdominal aortic aneurysm. In Korea, open repair is more widely available than EVAR, although EVAR can be performed in several hospitals. Due to the rapidly aging population in Korea, there has been a shift from private healthcare to government-regulated universal coverage and EVAR may be a more feasible option for cardiovascular interventionalists in these days. The improvement of EVAR was rapidly attained by many pioneers for the last two decades. Although issues such as indications and durability of EVAR remain to be elucidated, its application can be extended further of milder invasiveness-related effects on comorbidities and less discomfort to patients. Aortic stent-grafting has been performed for various aortoiliac pathologies over the last 13 years at our cardiovascular center.1-3) This article presents a comprehensive review on EVAR by focusing on the clinical trials, indications, complications, and expertise in decision making for EVAR.

Keyword

Aortic aneurysm; Abdominal aorta; Stent

MeSH Terms

Aging
Aneurysm
Aorta, Abdominal
Aortic Aneurysm
Aortic Aneurysm, Abdominal*
Comorbidity
Decision Making
Delivery of Health Care
Humans
Korea
Pathology
Stents
Universal Coverage

Figure

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  Fig. 1 Successful endovascular aneurysmal repair in a patient with abdominal aortic aneurysm (AAA). Pre-interventional (A) and post-stent-graft implantation (B) aortograms show marked improvement in distal blood flow propagation. Pre-interventional (C) and post-stent-graft implantation (D) computer tomography show stabilization of the aortic diameter and extraluminal thrombosis without leakage.

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  Fig. 2 An urgent stent-graft repair in a patient with abdominal aortic rupture who was diagnosed with Beçhet disease. Pre-interventional computer tomography (A) shows leakage around the lower abdominal aorta, and the post-interventional image (B) shows no further deterioration or complication.

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  Fig. 3 Type I endoleak after stent-graft implantation. A: immediate post stent-graft implantation aortogram shows no visible endoleak. B: one year after stent-graft implantation, there occurred type I endoleak (black arrow) with newly developed angulation of proximal stent-graft edge due to remodeling of the abdominal aorta.

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  Fig. 4 Complications after stent-graft implantation: two cases of thrombosis of the left limb of stent-graft who were treated with open fem-to-fem bypass graft repair.

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