A 10-year single-center prospective study of endovascular abdominal aortic aneurysm repair with the talent stent-graft.
OBJECTIVE
To report a 10-year prospective study of patients submitted to endovascular treatment for infrarenal abdominal aortic aneurysms (AAA).


METHODS
Between June 1997 and June 2007, 337 patients (284 men; mean age 72.5+/-7.4 years, range 52-89) with AAA underwent endovascular aneurysm treatment (EVAR) with implantation of Talent stent-grafts. The mean AAA diameter was 59.0+/-14.4 mm. All patients were clinically followed using computed tomography in the immediate post surgery period (15-30 days), after 6 months, and yearly thereafter. Plain abdominal radiography was performed yearly to assess the metallic components of the stent-grafts. Data concerning endoleaks, secondary procedures, and aneurysm diameter behavior were evaluated. Survival was evaluated using Kaplan-Meier estimates.


RESULTS
Endoprosthesis implantations were successful in 99.1% (334/337). There were 2 surgical conversions, and the delivery system could not be inserted in 1 female patient. The perioperative mortality was 3.9% (n = 13). Nineteen (5.7%) aneurysms showed endoleaks during the first 30 days (6 type I and 13 type II); 5 type I and 3 type II endoleaks were repaired (secondary clinical success of 92.6%). Another 15 late endoleaks were detected (4 type I, 5 type II, 3 type III, 1 type IV, 2 endotension), for a total of 34 (10.2%) endoleaks. Follow-up (mean 58.7 months, range 12-120) was available in 273 (81.0%) patients. During this time, there were 2 (0.7%) aneurysm ruptures, 1 due to type III endoleak and the other to endotension. Over the course of the study, 75 patients died; the estimated survival rates by the Kaplan-Meyer analysis were 67.3% after 5 years and 54.2% after 7 years. The mean AAA diameter decreased to 45.7+/-18.4 mm (p<0.001 versus mean postoperative diameter) at 60 months and to 37.8+/-15.0 mm at 120 months (p<0.019).


CONCLUSIONS
Endovascular aneurysm treatment with the Talent stent-graft has proven to be effective in the prevention of AAA rupture into the long term.
Espinosa
Gaudencio
G
Department of Vascular Surgery of the Federal University of Rio de Janeiro, Brazil. g.espinosa@uol.com.br
Ribeiro Alves
Marcia
M
Ferreira Caramalho
Monica
M
Dzieciuchowicz
Lukasz
L
Santos
Sergio Ricardo
SR
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000517:prevention & control*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D018570:Risk Assessment; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome