The efficacy of transfemoral endovascular aneurysm management: a study on size changes of the abdominal aorta during mid-term follow-up.
OBJECTIVE
The aim of this study was to assess efficacy of transfemoral endovascular aneurysm management (TEAM) during mid-term follow-up.


METHODS
Prospective multicentre study.


METHODS
In 26 patients treated by a Tube Endograft, the pre- and postoperative contrast enhanced computed tomography (CT) images were reviewed in a blinded fashion. Aortic diameters were measured at the coeliac trunk, the inferior and superior aneurysm neck and the level of the maximal aneurysm size. The changes in diameter were related to the presence or absence of an endoleak.


RESULTS
The median follow-up was 12 months. In 10 patients an endoleak was found. Three endoleaks sealed spontaneously within 30 days after operation. All aneurysms with persistent endoleaks expanded, at a median rate of 0.30 mm per month. Four patients were converted between 9 and 14 months after TEAM. Aneurysms excluded by the endoprosthesis showed a median shrinkage of 0.41 mm per month. The inferior aneurysm neck demonstrated significant growth during follow-up, unrelated to endoleaks.


CONCLUSIONS
This study demonstrated the efficacy of TEAM in discontinuing the process of aneurysm expansion. Complete seal of the aneurysm sac after TEAM leads to shrinkage or arrest of growth of the aneurysm, while persistent endoleak is associated with progressive expansion.
Broeders
I A
IA
Department of Surgery, University Hospital Utrecht, The Netherlands.
Blankensteijn
J D
JD
Gvakharia
A
A
May
J
J
Bell
P R
PR
Swedenborg
J
J
Collin
J
J
Eikelboom
B C
BC
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D018709:Statistics, Nonparametric; D015607:Stents / Q000706:statistics & numerical data; D013997:Time Factors; D014057:Tomography, X-Ray Computed