Long-term single-center results with AneuRx endografts for endovascular abdominal aortic aneurysm repair.
OBJECTIVE
To evaluate the long-term single-center results with the AneuRx stent-graft in endovascular abdominal aortic aneurysm (AAA) repair (EVAR).


METHODS
Between December 1996 and August 2003, 212 patients (197 men; mean age 71.3+/-7.0 years) were treated with the AneuRx stent-graft for an infrarenal AAA. Postoperatively, patients were enrolled in a fixed surveillance protocol, and data were prospectively captured into a database.


RESULTS
Graft deployment was successful in 98.6% (209/212). Thirty-day mortality was 2.4%. Median hospital stay was 4.3+/-5.5 days. Median follow-up was 52.0 months (range 1-109); only 1 patient was lost to follow-up. At 9 years, patient survival was 56% and freedom from secondary interventions was 48%. In 68% of cases, these reinterventions were needed for a fixation-related complication, and most of these complications (75%) encompassed the area of the proximal aneurysm neck. Primary clinical success was 37% at 9 years. After secondary interventions, the assisted primary clinical success improved to 73% at 9 years. Freedom from aneurysm-related death was 97% at 1 year and 90% at 9 years.


CONCLUSIONS
As an alternative to open repair, EVAR with the AneuRx device has low perioperative mortality. Reinterventions are mostly due to fixation-related complications. While the overall mortality risk in this population was 5% per year, annual aneurysm-related death was only 1%. The focus should be on surveillance and reducing the rate of long-term complications, which might be possible with improved proximal stent-graft fixation.
van Herwaarden
Joost A
JA
Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
van de Pavoordt
Eric D W M
ED
Waasdorp
Evert J
EJ
Albert Vos
Jan
J
Overtoom
Tim ThC
TT
Kelder
Johannes C
JC
Moll
Frans L
FL
de Vries
Jean-Paul P M
JP
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012086:Reoperation; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome