[Endovascular repair of abdominal aortic aneurysm. Results in 80 consecutive patients].
BACKGROUND
Endovascular repair of abdominal aortic aneurysms (AAA) avoids laparotomy, shortens hospital stay and reduces morbidity and mortality related to surgical repair, allowing full patient recovery in less time.


OBJECTIVE
To report short and long term results of endovascular repair of AAA in 80 consecutive patients treated at our institution.


METHODS
Between September 1997 and February 2005, three women and 77 men with a mean age 73.6+/-7.7 years with AAA 5.8+/-1.0 cm in diameter, were treated. The surgical risk of 38% of patients was grade III according to the American Society of Anesthesiologists classification. Each procedure was performed in the operating room, under local or regional anesthesia, with the aid of digital substraction angiography. The endograft was deployed through the femoral artery (83.7% bifurcated, 16.3% tubular graft). A femoro-femoral bypass was required in 11.3% of cases. Follow-up included a spiral CT scan at 1, 6 and 12 months postoperatively, and then annually.


RESULTS
Endovascular repair was successfully completed in 79/80 patients (98.7% technical success). The procedures lasted 147+/-71 min. Length of stay in the observation unit was 20.6+/-13.5 h. Blood transfusion was required in 10%. Sixty two percent of the patients were discharged before 72 h. One patient died 8 days after surgery due to a myocardial infarction (1.3%). During follow-up (3-90 months), 1 patient developed late AAA enlargement due to a type I endoleak, requiring a new endograft. No AAA rupture was observed. Survival at 4 years was 84.2% (SE =9.2). Endovascular re-intervention free survival was 82.7% (SE =9.5).


CONCLUSIONS
Endovascular surgery allows effective exclusion of AAA avoiding progressive enlargement and/or rupture and is a good alternative to open repair. Close and frequent postoperative follow up is mandatory.
Valdés
Francisco
F
Cirugía Vascular y Endovascular, Departamento de Enfermedades Cardiovasculares y División de Cirugí, Facultad de Medicina, Pontificia Universidad Católica de Chile. franval@med.puc.cl
Mertens
Renato
R
Krämer
Albrecht
A
Bergoeing
Michel
M
Mariné
Leopoldo
L
Canessa
Roberto
R
Huete
Alvaro
A
Vergara
Jeanette
J
Valdebenito
Magaly
M
Rivera
Dixiana
D
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011300:Preoperative Care; D015607:Stents; D016019:Survival Analysis; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome