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Nuno Dias

Adjunct professor

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Intraoperative proximal endoleaks during AAA stent-graft repair: evaluation of risk factors and treatment with Palmaz stents


  • Nuno Dias
  • T Resch
  • Martin Malina
  • Bengt Lindblad
  • Krassi Ivancev

Summary, in English

PURPOSE: To study factors that might contribute to intraoperative proximal type I endoleak and to evaluate the placement of giant Palmaz stents as a therapeutic option. METHODS: Thirty-three patients (30 men; median age 72 years, range 50-85) with abdominal aortic aneurysms underwent implantation of fully supported Gianturco Z-stent-based endografts (12 custom-made aortomonoiliac and 21 bifurcated Zenith devices). Ten (30%) patients were treated for intraoperative proximal endoleaks. Stent-graft oversizing and neck angulation, length, and shape were compared between patients with and without leaks. RESULTS: In 9 cases, the endoleaks were successfully treated with intraoperative placement of Palmaz stents without complications. In 1 patient, a leak that was resolved intraoperatively with balloon dilation reappeared 1 month later; a Palmaz stent was deployed successfully. Stent-graft oversizing did not differ significantly between patients who developed proximal endoleaks and those who did not (median 4.0 mm in both groups, p = 0.47). Median neck length was 21.0 mm in patients with endoleak and 28.0 mm in those without (p > 0.99). Median neck angulation was 30 degrees in both groups (p = 0.33), and the presence of a conical aneurysm neck was not significantly different (2/10 versus 6/23, p > 0.99). All aneurysms remained excluded at a median follow-up of 13 months (range 6-24). CONCLUSIONS: Stent-graft oversizing and neck morphology (length, angulation, and conical shape) do not seem to correlate with the incidence of proximal type I endoleaks. Palmaz stent placement appears to be a feasible and safe treatment option for this complication.


  • Department of Clinical Sciences, Malmö
  • Vascular Diseases - Clinical Research
  • Radiology Diagnostics, Malmö

Publishing year







Journal of Endovascular Therapy





Document type

Journal article


International Society of Endovascular Specialists


  • Cardiac and Cardiovascular Systems


  • abdominal aortic aneurysm
  • Gianturco Z-stent
  • Zenith endograft
  • aortomonoiliac stent-grafting
  • complication



Research group

  • Vascular Diseases - Clinical Research
  • Radiology Diagnostics, Malmö


  • ISSN: 1545-1550