title: Long-term outcome and reintervention after endovascular abdominal aortic aneurysm repair using the Zenith stent graft.
abstract: OBJECTIVE
  To assess the long-term performance of the bifurcated Zenith stent graft.
  
  
  METHODS
  A total of 325 patients (300 men and 25 women) underwent elective endovascular abdominal aortic aneurysm repair with bifurcated Zenith stent grafts between October 1998 and December 2005. Follow-up included routine contrast-enhanced computed tomography and multiview abdominal radiographs at 1, 6, and 12 months and yearly thereafter. Data on late-occurring (>30 days after stent-graft implantation) complications and interventions were collected prospectively.
  
  
  RESULTS
  Of the original 325 patients, 92 have since died, resulting in a mean follow-up of 2.3 years (range, 1 month to 7.0 years). Nine (2.8%) of 325 patients required reintervention to treat or prevent endoleak (type I or III) or graft occlusion at an average of 1.4 years after stent-graft placement (range, 40 days to 4.0 years). Three (0.9%) of these patients died from causes related to malfunction of the stent graft: one each from aneurysm rupture, stent-graft infection, and infection of a femoral-femoral bypass graft placed after limb occlusion. Nineteen additional patients (5.8%) required treatment for type II endoleak, for a total reintervention rate of 8.6%.
  
  
  CONCLUSIONS
  Late failures of Zenith stent-graft attachment, structure, or function are rare. In the absence of known endoleak, routine follow-up imaging plays a limited role in the identification and prevention of impending failure.
authors.affiliation: Division of Vascular Surgery, University of California-San Francisco, San Francisco, CA, 94143, USA. hiramotoj@surgery.ucsf.edu
authors.forename: Jade S
authors.initials: JS
authors.lastname: Hiramoto
authors.forename: Linda M
authors.initials: LM
authors.lastname: Reilly
authors.forename: Darren B
authors.initials: DB
authors.lastname: Schneider
authors.forename: Nayan
authors.initials: N
authors.lastname: Sivamurthy
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Rapp
authors.forename: Timothy A M
authors.initials: TA
authors.lastname: Chuter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality; D019917:Blood Vessel Prosthesis Implantation; D002140:California; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000401:mortality; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome