Aortic aneurysm endovascular treatment of AAA

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Endovascular treatment of AAA
In the recent years, the endoluminal treatment of Abdominal Aortic Aneurysms has emerged as a minimally invasive alternative to open surgery repair. The first endoluminal exclusion of an aneurysm took place in Argentina by Dr. Parodi and his colleagues in 1991. The endovascular treatment of aortic aneurysms involves the placement of an endo-vascular stent via a percutaneous technique (usually through the femoral arteries) into the diseased portion of the aorta. This technique has been reported to have a lower mortality rate compared to open surgical repair, and is now being widely used in individuals with co-morbid conditions that make them high risk patients for open surgery. Some centers also report very promising results for the specific method in patients that do not constitute a high surgical risk group.

There have also been many reports concerning the endovascular treatment of ruptured Abdominal Aortic Aneurysms, which are usually treated with an open surgery repair due to the patient's impaired overall condition. Mid-term results have been quite promising. However, according to the latest studies, the EVAR procedure doesn't carry any overall survival benefit.

Endovascular treatment of other aortic aneurysms
The endoluminal exclusion of aortic aneurysms has seen a real revolution in the very recent years. It is now possible to treat thoracic aortic aneurysms, abdominal aortic aneurysms (please see above) and other aneurysms in most of the body's major arteries (such as the iliac and the femoral arteries) using endovascular stents and avoiding big incisions. Still, in most cases the technique is applied in patients at high risk for surgery as more trials are required in order to fully accept this method as the gold standard for the treatment of aneurysms.

Endoleak

 * Endoleak is a complication of endovascular aneurysm repair.
 * The endoleaks may continue to perfuse and pressurize the aneurysm sac, thereby conferring an ongoing risk of aneursym enlargement and/or rupture.
 * Endoleaks are classified by the source of blood flow, and organized into five categories.


 * I: Attachment site leaks
 * II: Collateral vessel leaks
 * III: Graft failure (i.e. midgraft hole, junctional leak or disconnect)
 * IV: Graft wall porosity
 * V: Endotension (with or without endoleak)

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