@Article{Szaniewski2016,
journal="Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery",
issn="1731-5530",
volume="13",
number="4",
year="2016",
title="Predeployed aortic extension cuff (kilt) in EVAR with hostile neck anatomy using Endurant II system: preliminary results",
abstract=" Introduction : Various modifications of standard endovascular aortic aneurysm repair (EVAR) have been developed to solve the problem of difficult neck anatomy.   Aim:  The authors propose the implantation of a predeployed extension cuff (kilt) using on-shelf Endurant II elements. In a vast majority of cases, the proposed method provides a solution for the hostile neck problem using standard Endurant II elements available in all centers performing subrenal EVAR procedures.   Material and methods:   The early outcomes of kilt implantation were evaluated in 11 patients (three with ruptured abdominal aortic aneurysms, one symptomatic) in 2 vascular centers in Silesia (Poland). All patients presented with hostile neck anatomy defined as neck length   28 mm, angulation > 60°, mural thrombus or calcium > 2 mm in thickness or > 180° circumference.   Results:   No intraoperative type I endoleak or device migration was observed. Two perioperative deaths occurred in patients in a severe condition with ruptured aneurysms. One case of type III endoleak was managed by the implantation of an additional iliac extension with complete endoleak sealing.   Conclusions : The proposed method seems to be effective in early endoleak prevention in patients with hostile neck anatomy undergoing EVAR procedures; however, studies with long-term follow-up are needed.",
author="Szaniewski, Krzysztof
and Biernacka, Magdalena
and Walas, Ryszard L.
and Zembala, Marian",
pages="334--339",
doi="10.5114/kitp.2016.64876",
url="http://dx.doi.org/10.5114/kitp.2016.64876"
}