PURPOSE: To describe the efficacy and value of endovascular stent-grafts for the treatment of aortic anastomotic pseudoaneurysms. METHODS: Three patients with proximal aortic anastomotic pseudoaneurysms 8--15 years after prosthetic reconstruction were treated by transfemoral stent-graft implantation. In two patients the pseudoaneurysms were excluded by Talent prostheses [tube graft (n = 1), bifurcated graft (n = 1)]. In one patient an uniiliac Zenith stent-graft was implanted and an extra-anatomic crossover bypass for revascularization of the contralateral lower extremity was performed. RESULTS: All procedures were successful with primary exclusion of the pseudoaneurysms. During the follow-up (mean 16 months) one endoleak occurred due to migration of the tube stent-graft. The endoleak was sealed successfully by implanting an additional bifurcated stent-graft. CONCLUSION: Stent-graft exclusion of aortic pseudoaneurysms offers a minimally invasive and safe alternative to open surgical reconstruction.

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[Arterial complications caused by using an axillary crutch].

BACKGROUND: Of all upper extremity emboli, up to twenty percent arise from an arterial, not a cardiac source. METHOD: We report about a patient with recurrent embolism, caused by an axillary crutch-induced aneurysm of the axillary artery. RESULT: After revascularisation by embolectomy and axillo-brachial vein graft bypass, the patient was free of symptoms. CONCLUSION: Angiography and duplex scanning were necessary for the correct diagnosis.

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Results and complications in endovascular treatment of abdominal aortic aneurysms--a single center experience.

Between September 1996 and February 2000 five female and 62 male patients with an abdominal aortic aneurysm, requiring therapy, underwent endoluminal treatment. Their age ranged from 51 to 81 years (mean 72 years). Preoperative evaluation was done with spiral computed tomography (CT) and angiography. All procedures were performed under general anesthesia in a radiologically adapted operating room. Postoperative complications occurred in 28.4%. The total conversion rate was 13.4%, the 30-day lethality rate was 1.4%. During the mean follow-up of 15.1 months 19 secondary interventions were necessary in 13 patients. The results presented in this study do not justify the wide use of this method and indicate a stricter form of patient selection.

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