Endovascular exclusion of abdominal aortic aneurysms initial experience with stent-grafts in cardiology practice

• Published in: Texas Heart Institute journal Vol. 27; no. 2; pp. 136 - 145
• Main Authors: HOWELL, M. H, ZAQQA, M, VILLAREAL, R. P, STRICKMAN, N. E, KRAJCER, Z
• Format: Journal Article
• Language: English
• Published: Houston, TX Texas Heart Institute 2000
• Subjects: Aged; Aortic Aneurysm, Abdominal - surgery; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Cardiology. Vascular system; Diseases of the aorta; Equipment Design; Female; Follow-Up Studies; Humans; Male; Medical sciences; Peripheral Interventions; Polytetrafluoroethylene; Postoperative Complications - epidemiology; Prospective Studies; Stents; Time Factors; Arterial disease; Vascular disease; Abdominal aorta; Human; Endoprosthesis; Prognosis; Treatment; Aneurysm; Cardiovascular disease; Technique; Aortic disease; Percutaneous route
• ISSN: 0730-2347; 1526-6702

The use of an endovascular stent-graft prosthesis for the treatment of infrarenal abdominal aortic aneurysms is receiving increasing attention as an option that may avoid the significant morbidity and mortality associated with open surgical treatment. We studied the clinical effectiveness of stent-grafts in patients with infrarenal abdominal aortic aneurysms. Between October 1995 and May 1998, 33 patients underwent infrarenal abdominal aortic aneurysm exclusion with a homemade polytetrafluoroethylene-covered stent, and between November 1998 and September 1999, 56 patients underwent abdominal aortic aneurysm exclusion with the Medtronic AneuRx stent-graft. Overall, these patients represented a high-risk surgical group. The technical success rate was 100% in both groups. No patient required immediate conversion to open repair. With the polytetrafluoroethylene-covered stent, the primary success rate was 33%, and the secondary success rate was 76%. In the AneuRx group, the primary success rate was 82.8%, and the secondary success rate was 85.3% at 6 months. There was no procedural or 1-month mortality or major morbidity in either group. By showing that infrarenal abdominal aortic aneurysms can be treated safely and successfully with an endoluminal stent-graft, our early results provide additional support for the endovascular treatment of abdominal aortic aneurysms. Further follow-up studies will determine the long-term ability of such treatment to prevent aneurysmal rupture and death.