Does endovascular grafting represent a giant step forward?

Endovascular repair of abdominal aortic aneurysms was first reported in 1991 by Parodi et al. Since then, there has been widespread development of many stent-grafts for abdominal aortic aneurysm (AAA) repair. Available data support the proposition that stent-grafts are generally safe, although their...

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Bibliographic Details
Published inSeminars in vascular surgery Vol. 12; no. 3; p. 235
Main Authors Abou-Zamzam, Jr, A M, Porter, J M
Format Journal Article
LanguageEnglish
Published United States 01.09.1999
Subjects
Aortic Aneurysm, Abdominal - surgery
Blood Vessel Prosthesis Implantation
Humans
Postoperative Complications
Prosthesis Failure
Stents
Treatment Outcome
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Summary:Endovascular repair of abdominal aortic aneurysms was first reported in 1991 by Parodi et al. Since then, there has been widespread development of many stent-grafts for abdominal aortic aneurysm (AAA) repair. Available data support the proposition that stent-grafts are generally safe, although their long-term efficacy remains completely unknown. Importantly, endovascular AAA repair has neither fewer complications nor lower mortality rates than open repair; in fact, the opposite appears true. Along with most new techniques come new complications, and endovascular repair of AAA has brought forth the concept of both "endoleak" and device failure. Although it is uncommon, delayed AAA rupture after seemingly successful endovascular repair of AAA has been reported. In our opinion, these faults unique to endovascular repair mandate a cautious approach to the clinical application of stent-grafts. Until ongoing phase 2 and future phase 3 studies are completed with a minimum of 2 to 3 years' follow-up, we shall not know whether endovascular repair of AAA represents a giant step forward or merely an industry-driven overuse of proprietary technology.
ISSN:0895-7967