VASCULAR REVIEWSThe Perth HLB bifurcated endoluminal graft: A review of the experience and intermediate results
Section snippets
Material and methods
Patients with aneurysmal disease of the infrarenal aorta and iliac arteries with a high risk of open surgery were considered for endoluminal graft. Patients were considered high risk if their age was greater than 80 years or there was history of cardiac disease, respiratory disease, end stage chronic renal failure, hostile abdomen, haematological abnormalities or previous cerebrovascular accident. After fulfilling the criteria for endoluminal grafting, patients were assessed for anatomical
Results
Since 1993, a total of 136 endoluminal grafts have been placed for aneurysmal disease of which 108 have been bifurcated grafts for infrarenal aorto-iliac aneurysmal disease. All the grafts were made in one institution and had similar components.
For the bifurcated system, the operating time and blood loss reduced with experience and improvement in technique and devices used (Table 1): initial technical success in deployment and exclusion of the aneurysm was achieved in 94 cases. Secondary
Discussion
The technical success rates, early and late complications and endoleaks are similar to other reports in the literature 4, 5, 6. Lessons learnt from our experience are discussed below and reinforce the reports from other centres that perform endoluminal grafting 4, 5, 6, 7, 8.
Future predictions
The ultimate aim of endoluminal grafting is to treat any aneurysm at any site by a percutaneous technique. To accomplish the first of these objectives, fenestrated grafts or grafts with extension pieces to visceral vessels will allow treatment of aneurysms involving the visceral arteries: to insert a complete endograft percutaneously if the delivery system and the graft need to be reduced in size, while maintaining their strength and durability. Newer materials for both components will be
References (8)
- et al.
The Perth endoluminal bifurcated graft system-development and early experience
Cardiovascular Surgery
(1996) - et al.
Endoluminal aortic aneurysm repair using a balloon expandable stent graft
Annals of Vascular Surgery
(1994) - et al.
Transfemoral endoluminal repair of abdominal aortic aneurysm with bifurcated graft
Lancet
(1994) Symposium on transluminally placed endovascular prostheses, Bethesda, Maryland, USA, 24–26 March 1994. Introduction and overview
Cardiovascular Surgery
(1995)