The changing management of primary XXXX .

@entity1 @entity5880 @entity449 @entity2334 @entity439 @entity397
OBJECTIVE: The objective of this study is to examine contemporary management of primary @entity449 in a single center. We have previously reported the management of @entity449 in 15 @entity1 between 1991 and 2001, and we hypothesized that management would change in the light of the evolution of endovascular aortic repair. METHODS: A review of a prospectively collected database (2002-2009) of all @entity1 presenting with @entity5880 . RESULTS: A total of 19 @entity439 were identified in 17 @entity1 (12 @entity1 , 5 @entity1 ) with a median age of 66.2 years (range, 49-82 years). All were symptomatic, and nine had contained @entity397 . There were five infrarenal, two juxtarenal, three Crawford type III, four type @entity2334 , and five descending @entity439 in the series. All @entity439 were excluded by @entity439 repair. Two @entity1 underwent visceral hybrid endografting for @entity2334 ; the third was treated with open repair. Four @entity1 underwent open type IV repair. Two of the @entity439 were treated with bifurcated @entity439 repair, and the other three and both juxtarenals with open repair with in situ reconstruction. There were three early (17.6%) and three late deaths (17.6%). The median follow-up was 30.5 months (range, 1-102 months). CONCLUSIONS: The results of the latest series show that open surgery is still required in many cases. The introduction of endovascular techniques in the exclusion of @entity5880 can be accomplished with acceptable results, and endovascular treatment has increased the therapeutic options for a difficult condition.
