title: Endoluminal stent-grafts for infrarenal abdominal aortic aneurysms.
abstract: BACKGROUND
  The treatment of aortic aneurysms with endovascular stents or stent-graft prostheses is receiving increasing attention as an alternative to major abdominal surgery. To define the clinical value of this technique, we prospectively studied the use of stent-graft endoprostheses made of nitinol and covered with polyester fabric for the treatment of infrarenal abdominal aortic aneurysms.
  
  
  METHODS
  We treated a total of 154 patients at three academic hospitals. Twenty-one patients with aortic aneurysms not involving the aortic bifurcation received straight stent-grafts, and 133 patients with aortic aneurysms involving the bifurcation and the common iliac arteries received bifurcated stent-grafts. After a unilateral surgical arteriotomy, the endoprostheses were advanced through the femoral arteries and placed under fluoroscopic guidance. Computed tomography and intraarterial angiography were performed during an average follow-up of 12.5 months.
  
  
  RESULTS
  The primary success rate, defined as complete exclusion of the abdominal aortic aneurysm from the circulation, was 86 percent in the group receiving straight grafts and 87 percent in the group receiving bifurcated grafts. In three patients the procedure had to be converted to an open surgical operation. Minor (n=13) or major (n=3) complications associated with the procedure (including 1 death) occurred in 10 percent of the patients. All patients had a postimplantation syndrome, with leukocytosis and elevated C-reactive protein levels.
  
  
  CONCLUSIONS
  Our results suggest that endovascular treatment of infrarenal abdominal aortic aneurysms is technically feasible and can effectively exclude abdominal aortic aneurysms from the circulation. With further refinement, endoluminal repair may emerge as an interventional strategy to treat infrarenal aortic aneurysms, especially in patients at high surgical risk.
authors.affiliation: Department of Diagnostic Radiology, University Hospital, Freiburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Blum
authors.forename: G
authors.initials: G
authors.lastname: Voshage
authors.forename: J
authors.initials: J
authors.lastname: Lammer
authors.forename: F
authors.initials: F
authors.lastname: Beyersdorf
authors.forename: D
authors.initials: D
authors.lastname: Töllner
authors.forename: G
authors.initials: G
authors.lastname: Kretschmer
authors.forename: G
authors.initials: G
authors.lastname: Spillner
authors.forename: P
authors.initials: P
authors.lastname: Polterauer
authors.forename: G
authors.initials: G
authors.lastname: Nagel
authors.forename: T
authors.initials: T
authors.lastname: Hölzenbein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D011091:Polyesters; C013616:nitinol