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Lessons learned in adopting endovascular techniques for treating abdominal aortic aneurysm. Arch Surg 2001 Jun;136(6):627-34

Date

06/26/2001

Pubmed ID

11386998

DOI

10.1001/archsurg.136.6.627

Scopus ID

2-s2.0-0034995335 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

HYPOTHESIS: Endovascular exclusion of abdominal aortic and common iliac aneurysms can be performed safely, and in the short term represents a feasible alternative to traditional, open aneurysm repair.

PATIENTS AND METHODS: Forty-one patients were treated with endovascular grafts for 39 abdominal aortic and 2 common iliac artery aneurysms.

RESULTS: All devices were successfully deployed. The size of the abdominal aortic aneurysms varied from 4.9 to 11.9 cm (average, 6.13 cm). The median procedure time was 195 minutes. There was one iliac artery rupture, which required celiotomy for repair. The hospital stay varied from 2 to 39 days (average, 6.7 days). The perioperative mortality rate was 2.4%. Sixteen patients (39%) had groin wound complications. Ten patients (24%) had evidence of contrast (endoleak) within the aneurysm sac on completion of the procedure. There were no obvious direct leaks from either the point of proximal or distal fixation. Seven of these endoleaks have resolved spontaneously. Two patients required additional procedures in the postoperative period to treat endoleak. The final patient has evidence of persistent endoleak on 3-month surveillance computed tomography scan. Major late problems occurred in 3 patients.

CONCLUSION: Patients with large abdominal aortic aneurysms and considerable cardiac comorbidity can safely undergo endovascular aneurysm repair. Femoral groin wound complications resulting in prolonged hospitalization remain the major cause of perioperative morbidity. In contradistinction to open aneurysm repair, long-term surveillance is essential to detect migration of the device and identify flow within the residual aneurysm sac-complications that could lead to aneurysm rupture following endovascular repair.

Author List

Patterson MA, Jean-Claude JM, Crain MR, Seabrook GR, Cambria RA, Rilling WS, Towne JB

Author

William S. Rilling MD, FSIR Vice Chair, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Angioplasty
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis Implantation
Comorbidity
Coronary Disease
Equipment Design
Female
Humans
Hypertension
Iliac Aneurysm
Length of Stay
Male
Middle Aged
Prospective Studies
Retrospective Studies
Stents
Time Factors
Tomography, X-Ray Computed
Treatment Outcome