title: An update of the Zenith endovascular graft for abdominal aortic aneurysms: initial implantation and mid-term follow-up data.
abstract: OBJECTIVE
  To evaluate the initial and mid-term results of the Zenith endovascular grafting system for infrarenal abdominal aortic aneurysms.
  
  
  METHODS
  Prospective databases at seven centers were used to assess a cohort of patients that underwent treatment for aortic, aortoiliac, or iliac aneurysms since 1995. Data were analyzed to yield descriptive characteristics that pertained to the patients, the aortic morphologic features, the graft configuration, and the complications. Follow-up imaging data were used to determine size changes of the aneurysm sac, endoleak rates, and further complications. Finally survival data were expressed with a Kaplan-Meier analysis.
  
  
  RESULTS
  A total of 528 patients were treated with the Zenith endograft. Most of the patients (66%) were considered to be at a high physiologic risk for open repair. Successful graft implantation was accomplished in all but four patients. An overall endoleak rate of 15% was noted, of which 4% was treated urgently because they were thought to represent attachment site faults. The mean follow-up period was 18 months. A total of eight endograft migrations were detected after 2 years of follow-up with an early version of the system. There were three late conversions; two ruptures occurred during the follow-up period.
  
  
  CONCLUSIONS
  This early and mid-term data support the use of the Zenith endovascular graft for the treatment of aortic and aortoiliac aneurysms in properly selected patients. The risks of significant complications or aneurysm rupture are low.
authors.affiliation: Department of Vascular Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Greenberg
authors.forename: M
authors.initials: M
authors.lastname: Lawrence-Brown
authors.forename: G
authors.initials: G
authors.lastname: Bhandari
authors.forename: D
authors.initials: D
authors.lastname: Hartley
authors.forename: W
authors.initials: W
authors.lastname: Stelter
authors.forename: T
authors.initials: T
authors.lastname: Umscheid
authors.forename: T
authors.initials: T
authors.lastname: Chuter
authors.forename: K
authors.initials: K
authors.lastname: Ivancev
authors.forename: R
authors.initials: R
authors.lastname: Green
authors.forename: B
authors.initials: B
authors.lastname: Hopkinson
authors.forename: J
authors.initials: J
authors.lastname: Semmens
authors.forename: K
authors.initials: K
authors.lastname: Ouriel
mesh_terms: D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D017544:Aortic Aneurysm, Abdominal / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects / Q000592:standards*; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects / Q000592:standards*; D016019:Survival Analysis; D016896:Treatment Outcome