Endovascular treatment of abdominal aortic aneurysms.
BACKGROUND
Endovascular treatment of abdominal aortic aneurysms is a rapidly evolving technique that has gained broad acceptance in the treatment of patients with abdominal aortic aneurysms.


METHODS
A review of the English literature was done to determine the short- and long-term outcomes of endovascular repair of abdominal aortic aneurysms. Reports of complications such as endoleak, graft migration, graft limb occlusion, aneurysm rupture, and aneurysm enlargement were evaluated.


RESULTS
Short-term results of endovascular repair of abdominal aortic aneurysms are excellent. The necessity for open conversions is less than 5%. The cumulative risk of aneurysm rupture is approximately 1% per year. The coverall incidence of graft limb occlusion was 2.8% in the follow-up period. The cumulative risk for a secondary procedure was 12% at 1 year, 24% at 2 years, and 35% at 3 years. Moderate and severe neck angulation was associated with an increased incidence of adverse events in the follow-up period. Endografts have the potential to become infected and develop aortoduodenal fistula. The treatment of ruptured aneurysms with endovascular grafts has been successful and a technique that is increasingly used.


CONCLUSIONS
Endovascular treatment of abdominal aortic aneurysm is an effective technique with excellent short-term results. The long-term results remain to be determined. Ongoing surveillance is necessary to avoid late complications of aneurysm rupture.
Towne
Jonathan B
JB
Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI 53226, USA. jtowne@post.its.mcw.edu
D017542:Aneurysm, Ruptured; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005548:Foreign-Body Migration; D006801:Humans; D011183:Postoperative Complications; D012086:Reoperation; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome