Abstract

Abstract Background Endovascular Aneurysm Repair (EVAR) is established procedure for management of both elective and ruptured abdominal aortic aneurysms (AAA). However, in several cases, standard EVAR with bilateral limb extension cannot be done due to complex anatomy or calcified contralateral iliac artery. In such cases AUI stent graft and Fem-Fem cross over is a feasible option. This study aims to assess the outcomes of AUI with or without fem-fem cross over performed in SMART centre over 8 years Method A retrospective study on patients who had repair of AAA using AUI between 2014-2022, with or without crossover. Demographic, procedural, and radiological data was collected through digital database. The outcomes were based on mode of admission, mortality rate, complications and patency rate of the graft at 2 years. Results A total of 28 patients had AUI between January 2014-January 2022. Median age was 79 years (59-94) with male predominance (85%). 50% of the patients presented with ruptured AAA, 46% had elective repair and 4% of patients presented with Acute limb ischaemia. 30-day mortality was found to be 21%. Local complications included endoleak, graft infection, groin bleeding, lymph leak and wound dehiscence and general complications included a predominance of HAP and cardiac issues. The patency rate was checked at 6 months, 1-2 years. 6-month patency of the graft was found to be 93%. Similarly, 1 and 2-year patency was also found to be 93% Conclusions AUI with or without Fem-Fem crossover is an acceptable alternative treatment modality for ruptured or non-ruptured AAAs despite involving an extra-anatomical bypass.

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