A modular aortouniiliac endovascular stent-graft is a useful device for the treatment of symptomatic and ruptured infrarenal abdominal aortic aneurysms: one-year results from a multicentre study.
BACKGROUND
Endovascular repair (EVAR) of acute symptomatic and ruptured abdominal aortic aneurysm (rAAA) can be difficult without a large stock of suitable graft sizes. We report a prospective European multicentre study of a modular aortouniiliac stent-graft.


METHODS
Seven centres, with elective EVAR experience, participated in the study. Sixty-five patients were enrolled from September 2002 - April 2005. Some 45 patients had rAAA and 20 were acutely symptomatic. Their median age was 74 (69-80.3) years, 49 (75%) were men. From a choice of 4 body and 4 limb sizes, stent-grafts were deployed under local or general anaesthesia.


RESULTS
The endovascular delivery system was introduced and the aneurysm excluded from the circulation in a median of 40 (30-60) minutes from the first incision. The median operative duration was 150 (120-190) mins, blood loss 300 ml (200-800). 33 (51%) operations were performed by a vascular surgeon alone. There were a total of 4 (6%) peri-operative re-interventions, endovascular (n=1), open (n=2) and thrombectomy (n=1). The peri-operative mortality in the rupture group was 40% and 10% in the symptomatic group.


CONCLUSIONS
Aortouniiliac stent-grafts provide rapid exclusion of rAAA. Suitably trained surgeons can do the operation without a radiologist's support. The mortality rate from rAAA treated with EVAR remains high.
Hinchliffe
R J
RJ
Department of Vascular and Endovascular Surgery, Nottingham University Hospital, Nottingham, UK. robhinchliffe@hotmail.com
Braithwaite
B D
BD
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016063:Blood Loss, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D012086:Reoperation; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome