title: Superiority of endovascular grafts compared to bare metal stents with transstent coil embolization for endovascular abdominal aortic aneurysm repair in patients at high risk for surgery.
abstract: We sought to determine the effectiveness of uncovered stents with aneurysm transstent coil embolization compared with endografts for percutaneous abdominal aortic aneurysm (AAA) repair. Thirty-six patients with AAA considered inoperable underwent endovascular repair using the Ancure bifurcated endograft or overlapping uncovered stents with transstent coil embolization. Procedural success, outcomes, serial aneurysm size, aneurysm blood flow, and growth ratios were compared between groups. One patient in each group died due to the procedure and two patients in the endograft cohort required acute surgical repair. After 2.0 +/- 0.8 years of follow-up, three patients required endograft placement, four surgical repair, three had AAA rupture, with two AAA-related deaths in the uncovered stent group. No late deaths or surgical conversion occurred in the endograft group. The primary AAA flow exclusion and aneurysm expansion rate and growth were superior in the endograft group and during follow-up. In high-risk patients with AAA, the use of endografts was superior compared to uncovered stents with transstent coil embolization for endovascular repair.
authors.affiliation: Division of Cardiology, University of Texas Medical School and Memorial Hermann Hospital, Houston, TX 77030, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Boccalandro
authors.forename: Alan
authors.initials: A
authors.lastname: Cohen
authors.forename: Barat
authors.initials: B
authors.lastname: Raval
authors.forename: Phoebe
authors.initials: P
authors.lastname: Chen
authors.forename: Andreas
authors.initials: A
authors.lastname: Muench
authors.forename: Hela
authors.initials: H
authors.lastname: Achour
authors.forename: Catherine
authors.initials: C
authors.lastname: Carter
authors.forename: Carol
authors.initials: C
authors.lastname: Underwood
authors.forename: Richard W
authors.initials: RW
authors.lastname: Smalling
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals