Endoluminal graft repair of abdominal aortic aneurysms by vascular surgeons at a nonclinical trial center.
The purpose of this study was to compare the early results and complication rates of commercially available endoluminal grafts (ELG) for abdominal aortic aneurysm (AAA) by a team of vascular surgeons at a nontrial center with those of published results from trial centers. A retrospective chart review of all patients undergoing endoluminal graft repair of AAA was made at the medical center. From October 1, 1999, to December 31, 2000, a team of vascular surgeons electively repaired AAAs in 100 patients at a regional referral center. Of these patients, 49 underwent repair with a commercially available ELG (35 AneuRx, 14 Ancure) whereas the remaining were repaired with an open operation. In the ELG group, the primary technical success rate was 100% with a 30-day mortality rate of 2.0%. The average hospital length of stay was 3.28 days with ICU stay of 1.20 days. The average operative estimated blood loss was 501 mL (100-2,500) with average transfusions of 0.49 unit packed red blood cells (prbc) (0-6). Eighty-eight percent of ELG patients left the hospital without complication. Seven patients (14%) required 11 follow-up procedures for complications including endoleak, limb or graft thrombosis, graft stenosis, distal embolization, or wound complications. Three of 26 patients (11%) with 6-month computed tomography follow-up had evidence of endoleak (2 have subsequently undergone lumbar embolization). Only 1 6-month follow-up patient had shown increased aneurysm size before endoleak treatment. A team of board-certified vascular surgeons at a nonclinical trial center can safely perform ELG for AAA with results similar to those of published series from trial centers.
Marek
J
J
Division of Vascular Surgery, University of New Mexico School of Medicine, 2ACC, 915 Camino de Salud NE, Albuquerque, NM 87131-5341, USA. jmarek@salud.unm.edu
Langsfeld
M
M
Dickinson
R B
RB
Tullis
M J
MJ
Kasirajan
K
K
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods; D001012:Aorta, Abdominal / Q000503:physiopathology; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D016063:Blood Loss, Surgical; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002983:Clinical Competence / Q000592:standards; D015897:Comorbidity; D013502:General Surgery / Q000592:standards*; D006268:Health Facilities / Q000592:standards*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D013044:Specialty Boards; D016896:Treatment Outcome