[Initial clinical experiences with endovascular stent-grafts for treatment of infrarenal abdominal aortic aneurysm].
With a series of 34 transluminal stent-graft procedures, we assessed the feasibility and clinical effectiveness of a new stent-graft for the treatment of infrarenal abdominal aortic aneurysms (AAAs). We treated 34 male patients (mean age 71 years) with straight of bifurcated nitinol stents covered with woven Dacron graft material for infrarenal excentric saccular AAA (n = 3) or AAA involving the bifurcation and the common iliac arteries (n = 31). The 18-F delivery system was advanced via a surgical arteriotomy and the stent-graft was placed under fluoroscopic control. Follow-up period ranged from 8 days to 13 months. The implantation of the stent-grafts was technically successful with exclusion of AAA in 31/34 cases (91%). In 2 patients, there was a persisting leak at the distal end of the endoprosthesis after treatment; in another, marked coiling of the external iliac artery impeded the delivery system to be advanced and consecutive rupture resulted in conversion to surgical repair. Other procedure-related complications were acute hepatic failure due to gastric bleeding in a patient with liver cirrhosis, graft occlusion due to emboli originating from the left atrium (n = 1), local hematoma (n = 1), and AV-fistula (n = 1) requiring surgery. A post-implantation syndrome with leucocytosis and elevated C-reactive protein was observed in all patients. Endoluminal repair of infrarenal AAA with use of Dacron covered nitinol stent-grafts is feasible, safe and clinically effective. However, careful long-term evaluation is necessary before it will become clinical practice.
Spillner
G
G
Abteilung Herz- und Gefässchirurgie, Universitätsklinik Freiburg.
Blum
U
U
Langer
M
M
Schlosser
V
V
Beyersdorf
F
F
D000368:Aged; D000497:Alloys; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000628:therapy*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008297:Male; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015607:Stents; D014057:Tomography, X-Ray Computed
D000497:Alloys; D011093:Polyethylene Terephthalates; C013616:nitinol