The Zenith aortic stent-graft: a 5-year single-center experience.
OBJECTIVE
To evaluate the efficacy and midterm results of the Zenith stent-graft in the treatment of abdominal aortic aneurysms (AAA).


METHODS
Since March 1994, 364 patients have undergone endovascular repair of infrarenal AAA. Of the 94 who were treated with the Zenith stent-graft from 1996 to 2002, 88 patients (82 men; mean age 72.6 +/- 6.5 years, range 47-88) with at least 6-month follow-up were analyzed. Sixty-one (69.3%) patients were considered at high risk for intervention; 7 ruptured AAAs were treated emergently. In all, 68 (77.3%) bifurcated stent-grafts (including 18 TriFab systems) and 20 aortomonoiliac configurations were used. Cumulative data on endoleak, migration, secondary procedures, and survival were evaluated with Kaplan-Meier analyses.


RESULTS
Implantation success was 97.7%; 2 (2.3%) access-related failures were converted to open repair (1 immediate, 1 at 3 months). There were 3 (3.4%) graft limb thromboses (2 immediate, 1 late), 3 (3.4%) cases of colon ischemia due to embolization in 1 and hypogastric artery occlusion in 2, and 1 (1.1%) renal infarction due to embolism. Three (3.4%) patients died within 30 days. Eleven (12.5%) endoleaks and 1 (1.1%) late endograft migration were recorded. The 5-year cumulative endoleak and migration rates were 15% and 7%, respectively. Sixty-three (71.6%) patients did not present any complication related to the repair during a mean follow-up of 20.6 +/- 14.9 months (range 6-68); notably, no complications were associated with the 18 TriFab systems. Six (6.8%) secondary procedures were performed (31% 5-year cumulative secondary procedural rate). All 6 (6.8%) aneurysm-related deaths (the 3 perioperative, 2 from late AAA rupture, and 1 during a secondary procedure) and 14 of 18 (20.4%) non-aneurysm-related deaths occurred in high-risk patients; the 5-year cumulative survival rates were 57% for any death and 92% for aneurysm-related deaths.


CONCLUSIONS
The Zenith stent-graft appears both safe and effective in terms of midterm outcome of endovascular aortic aneurysm repair.
Alric
Pierre
P
Department of Vascular and Endovascular Surgery, University Hospital, Nottingham, England, UK. pierrealric@hotmail.com
Hinchliffe
Robert J
RJ
MacSweeney
Shane T R
ST
Wenham
Peter W
PW
Whitaker
Simon C
SC
Hopkinson
Brian R
BR
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000637:transplantation*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D001807:Blood Vessel Prosthesis; D004739:England / Q000453:epidemiology; D004867:Equipment Design; D005121:Extremities / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D015607:Stents; D016019:Survival Analysis; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation