Endovascular repair of abdominal aortic aneurysms using 3 commercially available devices: midterm results.
OBJECTIVE
To report the early and midterm results of 3 commercially available stent-grafts for abdominal aortic aneurysm (AAA) exclusion.


METHODS
Since fall 1999, 151 patients (137 men; mean age 74 years, range 54-88) have undergone AAA repair using 88 Ancure, 46 AneuRx, and 17 Excluder stent-grafts in elective procedures. All patients were followed clinically and underwent postoperative duplex ultrasound and/or computed tomographic angiography, which was repeated every 6 months.


RESULTS
The mean overall follow-up was 17 months (range 1-46). Initial technical failure was 3% (3/88) for Ancure versus 0% for AneuRx and Excluder. Primary endoleak occurred in 8% (7/88) of the Ancure patients versus 22% (10/46) for AneuRx and 6% (1/17) for Excluder (p=NS). Early (30-day) graft thrombosis (2/151, 1%) was seen only in the Ancure group. The perioperative complication rates (excluding endoleak and fever) were 22% (19/ 88) for Ancure, 15% (7/46) for AneuRx, and 0% for Excluder (p=NS). There was only 1 (0.7%) perioperative death in the series (Ancure patient). More ancillary procedures were performed in the Ancure group (p<0.05). Postoperatively, the size of the AAA decreased or remained unchanged in 76% for Ancure patients versus 75% for AneuRx and 64% for Excluder (p=NS). The incidences of late endoleak were 6% for Ancure, 2% for AneuRx, and 0% for Excluder (p=NS). The freedom from late endoleak at 3 years was 88% for Ancure and 97% for AneuRx (100% at 1 year for Excluder). Survival rates were similar. No AAA rupture was recorded.


CONCLUSIONS
The Ancure device has slightly higher overall perioperative complications and early technical failure than AneuRx or Excluder. All 3 devices are effective in preventing aneurysm rupture; the overall midterm survival rates, freedom of endoleak, and limb patency are somewhat similar.
Aburahma
Ali F
AF
Vascular Center of Excellence and Department of Surgery, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, West Virginia 25304, USA. ali.aburahma@camc.org
Stone
Patrick A
PA
Bates
Mark C
MC
Khan
Tariq N
TN
Prigozen
Jason M
JM
Welch
Christine A
CA
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D011336:Probability; D011379:Prognosis; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler