Endovascular repair of abdominal aortic aneurysm using the EVT device: limited increased utilization with availability of a bifurcated graft.
OBJECTIVE
To determine if the availability of a bifurcated graft would increase the percentage of patients eligible for endovascular repair of abdominal aortic aneurysms (AAAs).


METHODS
One hundred eighty-five consecutive patients were evaluated prospectively for endovascular AAA repair at a university referral center. Data were collected on eligibility for tube or bifurcated endovascular grafts, reasons for exclusion, aneurysm morphology, and the interventions performed.


RESULTS
Forty-six (25%) patients were eligible for endovascular treatment using the first-generation Endovascular Technologies (EVT) system: 19 (10%) for a tube graft and 27 (15%) for a bifurcated device. An unsuitable proximal neck was the reason for exclusion in 48% of patients (excess diameter in 27%, inadequate length in 21%). Unsuitable iliac configuration was present in 41% of those excluded; 29% of the common iliac arteries were enlarged or aneurysmal, while 12% were small or tortuous.


CONCLUSIONS
Although a bifurcated graft more than doubles the eligibility of AAA patients for endovascular repair, the configuration of the proximal neck and iliac disease excluded the majority of AAA patients from endovascular therapy using the first generation EVT device.
Sarkar
R
R
Division of Vascular Surgery, UCLA Medical Center, Los Angeles, California 90095-6904, USA.
Moore
W S
WS
Quiñones-Baldrich
W J
WJ
Gomes
A S
AS
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome