[Early and mid-term results of endovascular aneurysm repair for infrarenal abdominal aortic aneurysm].
OBJECTIVE
Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) has become a viable alternative to open surgical repair in the last decade. We report here our experience on the mid-term results of EVAR and analysis of the outcomes associated with endograft AAA repair.


METHODS
Between Nov 2002 and Mar 2007, 26 patients with AAA were enrolled in a single institution. Indications for EVAR included unfavorable condition of body (eg. Heart, lung, or renal dysfunction, etc) for open surgery and maximum diameter of AAA > 5.0 cm. Customized stent-grafts were Talent TM, Zenith and some of products made in China. All of the patients were followed up with ultrasonography or computed tomography angiography every 3 months first year after EVAR and every year after.


RESULTS
The mean (SD) follow-up was 38.8 ± 12.7 months (median, 35.0 months; range, 24 to 64 months), and no patients were lost to follow-up. All cause mortality was 15.4% (4/26), with all deaths occurring within the first 2 postoperative year; 30-day mortality was 4.1%. No patient died during the operation. Completion angiography demonstrated successful sealing in 25 of 26 patients. There was no stent occlusion of renal artery. The mid term complication were observed including 2 type I endoleak after 3 months of the operation, 2 sustained type II endoleak caused by lumber artery, 1 aneurysm of left femoral artery after 16 months of operation, 1 proximal neck dilation after 12 month of operation. The aneurysm sac size didn't increase significantly during follow time, except one of the type I endoleak.


CONCLUSIONS
The mid-term results of EVAR support the continued use in patients with contraindications for traditional open surgery of AAA. Close surveillance is mandatory for endoleak, especially for type I endoleak. Some proximal neck dilation can be caused by the stent-graft expansion, injury, and aortic pathological changes. Endoleak of type II can not lead to enlargement of aneurysm sac probably.
Wu
Xue-jun
XJ
Department of Vascular Surgery, Provincial Hospital Affiliated Shandong University, Jinan 250021, China.
Jin
Xing
X
Zhang
Shi-yi
SY
Chong
Zhen-yue
ZY
Zhang
Jing-yong
JY
Dong
Dian-ning
DN
Wang
Mo
M
Yuan
Hai
H
Sun
Yan
Y
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome