JUXTARENAL AORTIC-ANEURYSM - ENDOLUMINAL TRANSFEMORAL REPAIR

Endoluminal transfemoral repair of an abdominal aortic aneurysm by a s tent graft placement requires a segment of the nondilated infrarenal a orta of at least 15 mm long for safe stent graft attachment. The possi bility of endoluminal treatment of a juxtarenal abdominal aortic aneur ysm with partially covered spiral Z stent was assessed in experiment a nd in three clinical cases. In the experiment, the noncovered spiral Z stent was placed into the abdominal aorta, across the origins of rena l arteries and mesenteric arteries, in six dogs. In the clinical cases , a partially covered stent graft was attached in 3 patients with the juxtarenal abdominal aortic aneurysm (of the group of 12 patients with abdominal aortic aneurysm). The stent grafts were attached with proxi mal uncovered parts across the origins of the renal arteries. In exper i tment, the renal artery occlusions or stenoses were not observed 36 months after stent placement, and in clinic, 3 patients with the juxta renal aortic aneurysm were successfully treated by stent graft placeme nt. There were no signs of flow impairment into the renal arteries 14 months after stent graft implantation. This approach can possibly expa nd the indications for endoluminal grafting in the treatment of juxtar enal aortic aneurysms in patients who are at high risk for surgery.