title: Endovascular repair of abdominal aortic aneurysms: initial experience with 100 consecutive patients.
abstract: OBJECTIVE
  To review early results of endovascular repair of abdominal aortic aneurysms (AAAs).
  
  
  METHODS
  The first 100 patients who underwent endovascular repair of AAA (EVAR) between June 26,1996, and October 31, 2001, at the Mayo Clinic in Rochester, Minn, were studied retrospectively to evaluate technical success, freedom from reinterventions, and early clinical outcome.
  
  
  RESULTS
  A total of 89 men and 11 women (mean +/- SD age, 76 +/- 7 years; range, 47-92 years) underwent EVAR. The procedure was successful in 97 patients. There was no early death. Major complications occurred in 25 patients. The 30-day technical success rate was 86% (95% confidence interval [CI], 77%-92%). The median intensive care unit stay was 1 day (range, 1-15 days), and the median hospital stay was 3 days (range, 1-35 days). Median follow-up was 7 months (range, 1-60 months). Endoleak (incomplete seal of the endovascular graft) at discharge was observed in 14 patients; 13 developed endoleak during follow-up. There were 23 reinterventions, 65% of which were percutaneous procedures. One aneurysm ruptured at 5 months, but the patient was successfully treated by open repair. Primary and secondary graft patency rates at 1 year were 83% (95% CI, 74%-93%) and 94% (95% CI, 87 %-99%), respectively. The freedom from reintervention rate at 1 year was 71% (95% CI, 59%-84%), with an overall success rate from EVAR of 92% (95% CI, 84%-100%). There were no differences in early patency, reinterventions, and success rates between unibody and modular devices.
  
  
  CONCLUSIONS
  EVAR can be performed with high technical success and low mortality rates; however, nonfatal complications and catheter-based reinterventions are frequent, and EVAR may not prevent aneurysm rupture. Although stent graft repair for high-risk patients is appealing, current data are insufficient to support EVAR as the preferred treatment of AAAs.
authors.affiliation: Division of Vascular Surgery, Mayo Clinic, Rochester, Minn 55905, USA.
authors.forename: Stephane
authors.initials: S
authors.lastname: Elkouri
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
authors.forename: Michael A
authors.initials: MA
authors.lastname: McKusick
authors.forename: Jean M
authors.initials: JM
authors.lastname: Panneton
authors.forename: James C
authors.initials: JC
authors.lastname: Andrews
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Bower
authors.forename: Audra A
authors.initials: AA
authors.lastname: Noel
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Sullivan
authors.forename: Linda G
authors.initials: LG
authors.lastname: Canton
authors.forename: William S
authors.initials: WS
authors.lastname: Harmsen
authors.forename: Tanya L
authors.initials: TL
authors.lastname: Hoskin
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Cherry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents