title: Double tube stent-grafts for infrarenal aortic aneurysm: a new concept.
abstract: OBJECTIVE
  To present the concept of double tube stent-grafts and examine the indications for and results achieved with these devices.
  
  
  METHODS
  From January 1, 2000, to December 31, 2005, 759 patients who underwent endovascular repair of infrarenal aortic aneurysms at 2 centers. Of these, 45 (5.9%) patients received a double tube stent-graft; complete operative and follow-up data were available for retrospective analysis in 41 patients (33 men; mean age 73.1+/-8.9 years). Diameters measured before stent-graft implantation and at follow-up (12, 24, 36, and 48 months) with clinical examination, 2-phase computed tomographic angiography, duplex sonography, and biplanar abdominal radiography were tested for significant changes using ANOVA with the Bonferroni-Dunn correction. Late outcomes (clinical success and endoleak) were analyzed by the Kaplan-Meier method.
  
  
  RESULTS
  The postoperative complication rate was 12.2%, with 2.4% systemic complications (1 patient with angina pectoris); the early mortality rate was 0%. Mean follow-up was 21.9+/-12.8 months (range 12-61) for the 41 patients. Four (9.8%) patients died during follow-up of cardiac causes (n = 2), lung cancer (n = 1), and bowel ischemia (n = 1). Four (9.8%) endoleaks were observed during follow-up: 1 distal type I, 2 type II, and 1 type III. Maximum aneurysm diameters shrank from 52.0+/-9.5 mm preoperatively to 44.0+/-10.9 mm (p<0.0001) postoperatively at the latest available follow-up.
  
  
  CONCLUSIONS
  Our study supports the use of this double tube technique for repair of appropriate saccular infrarenal aortic aneurysms. The double tube stent-graft method appears safe in terms of endoleaks and migration, so we recommend that it be considered an option of endovascular aortic aneurysm therapy.
authors.affiliation: Department of Surgery, Hospital of Ludwig Maximilian University Munich-Campus Innenstadt, Germany. Volker.Ruppert@med.uni-muenchen.de
authors.forename: Volker
authors.initials: V
authors.lastname: Ruppert
authors.forename: Kerstin
authors.initials: K
authors.lastname: Erz
authors.forename: Dominik
authors.initials: D
authors.lastname: Bürklein
authors.forename: Marcus
authors.initials: M
authors.lastname: Treitl
authors.forename: Bernd
authors.initials: B
authors.lastname: Steckmeier
authors.forename: Wolf
authors.initials: W
authors.lastname: Stelter
authors.forename: Thomas
authors.initials: T
authors.lastname: Umscheid
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex