Long-term outcome and reintervention after endovascular abdominal aortic aneurysm repair using the Zenith stent graft.
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.
Hiramoto
Jade S
JS
Division of Vascular Surgery, University of California-San Francisco, San Francisco, CA, 94143, USA. hiramotoj@surgery.ucsf.edu
Reilly
Linda M
LM
Schneider
Darren B
DB
Sivamurthy
Nayan
N
Rapp
Joseph H
JH
Chuter
Timothy A M
TA
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