Regular paper
Mid-term results of patients undergoing endovascular aortic aneurysm repair

Presented at the 54th Annual Meeting of the Southwestern Surgical Congress, Coronado, California, April 7–10, 2002.
https://doi.org/10.1016/S0002-9610(02)01053-XGet rights and content

Abstract

Background

The utilization of endovascular aneurysm repair (EAR) is increasing significantly; however, few papers have outlined mid-term outcomes.

Methods

Patients undergoing EAR with an AneuRx endograft between September 1997 and May 2001 were evaluated. Mean follow-up was 20.7 ± 11.9 (SD) months.

Results

In all, 101 EAR devices were successfully deployed in 105 attempts. Four open conversions (2 acute, 2 delayed) were performed for complications of EAR. Technical, clinical, and 1 to 3 year continuing success rates were 75%, 73%, and 78% to 83%. When divided by the median date, significantly fewer patients in the later group required secondary procedures compared with the early group. Vascular insufficiency occurred in 12 patients; 11 were treated with a secondary procedure. For 9 type I and 9 type II persistent endoleaks, secondary procedures were attempted and successful in 10 patients. Of successful EAR deployments, including secondary interventions, 85% demonstrated no persistent leak, rupture, increase in aneurysm size, or migration at most recent follow-up.

Conclusions:

EAR is successful in selected individuals; however, continuing follow-up is of paramount importance.

Section snippets

Patients and methods

Between September 1997 and May 2001, 105 consecutive patients underwent attempted repair of infrarenal abdominal aortic aneurysms with the AneuRx endograft at the Ochsner Clinic Foundation. Patients were determined to be candidates for EAR based upon anatomic criteria identified by preoperative contrast-enhanced computed tomography (CT) scan and selectively obtained angiograms. Age, sex, presence of coronary disease, peripheral vascular disease, pulmonary disease, renal insufficiency,

Results

Between September 1997 and May 2001, 101 of 105 consecutive endovascular aneurysm repairs (EAR) experienced successful deployment of the AneuRx endograft. Two procedures were aborted for iliac access problems. Neither of these patients was considered an acceptable risk for conventional open repair because of comorbid illnesses; neither patient had follow-up at our institution. Two patients underwent acute conversion; specifically, 1 was converted for iliac artery dissection and the other for

Comments

Since its introduction by Parodi [7], EAR has become a viable alternative to and in many institutions has largely supplanted the standard open aneurysm repair. The endovascular technology, however, is fraught with device-related complications which mandate close follow-up and frequent secondary interventions, disadvantages when compared with open repair. Furthermore, the in-hospital cost alone of endovascular repair far exceeds that of open repair [8]. The 30-day mortality in this study was 2%,

Acknowledgements

Doctors Sternbergh, Yoselevitz, and Money are consultants for Medtronic/AVE. Medtronic/AVE has provided Drs. Sternbergh and Money with research support to administer FDA trials of their endograft.

Cited by (12)

  • Systematic Review and Meta-analysis of 12 Years of Endovascular Abdominal Aortic Aneurysm Repair

    2007, European Journal of Vascular and Endovascular Surgery
    Citation Excerpt :

    64 studies were rejected because they were case reports, letters or review articles; 49 studies did not include any endoleak or mortality data and were also rejected; 2 studies were rejected because their subjects were not human; 12 studies were not about ER of infrarenal aortic aneurysms and were therefore rejected, and a further 8 studies were rejected because they were found, at this stage, to be written in languages other than English. 16111–171 articles were deemed relevant for inclusion in this review and contained data pertaining to 28,862 patients. Ninety-six articles were Blankensteijn level 1b (prospective, hospital-based studies), 43 were level 2b (retrospective hospital-based studies) and the remaining 22 studies did not specify how data had been collected.7

  • What is the significance of endoleaks and endotension

    2004, Surgical Clinics of North America
  • Vascular graft complications

    2014, Harwood-Nuss' Clinical Practice of Emergency Medicine: Sixth Edition
View all citing articles on Scopus
View full text