title: Experience and outcomes after a decade of endovascular abdominal aortic aneurysm repair: a retrospective study from a community-based single center.
abstract: BACKGROUND
  The purpose of this study is to report the results of endovascular abdominal aortic aneurysm treatment based on the Zenith stent-graft from a community-based single center over a period of 9 years.
  
  
  METHODS
  We retrospectively analyzed immediate technical and clinical results as well as long-term outcomes in patients treated with endovascular aneurysm repair between 2001 and 2010. The study was performed in accordance with the recommendations of the ad hoc committee for standardized reporting practice in vascular surgery.
  
  
  RESULTS
  A total of 106 patients were treated in a period of 9 years. A Zenith stent-graft was used in 95% of cases. No deaths occurred during the first 30 days postsurgery. The complication rate was 4.7% (n = 5). The overall clinical and technical success rate at 30 days was 93.4%. After a mean follow-up period of 52 months (range, 13-112 months), the overall mortality rate was 25.4%. Aneurysm-related mortality was 2.1%. Rupture of the aneurysm occurred in four cases (4.3%). The final clinical failure rate was 13.8%. During the follow-up period, the mean diameter of the aneurysm decreased from 58.0 to 52.3 mm. However, expansion of the aneurysm was registered in 10 cases. Eleven patients had a primary endoleak, and another 11 secondary endoleaks occurred during the follow-up. The reintervention rate was 16.3%. The main reasons for repeat interventions were iliac limb occlusion (n = 5) and type 3 endoleak/limb disconnection (n = 4). Graft migration occurred in 3% of cases. A negative impact on sexual function after endovascular repair was reported by 20% of patients.
  
  
  CONCLUSIONS
  Endovascular repair is the treatment of choice for high-risk patients. A small but significant number of clinical failures were observed during the long-term follow-up.
authors.affiliation: Departments of Cardiac, Vascular and Thoracic Surgery, Klinikum Wels-Grieskirchen, Wels, Austria. manfred.kalteis@klinikum-wegr.at
authors.forename: Manfred
authors.initials: M
authors.lastname: Kalteis
authors.forename: Florian
authors.initials: F
authors.lastname: Haller
authors.forename: Andreas
authors.initials: A
authors.lastname: Artmann
authors.forename: Markus
authors.initials: M
authors.lastname: Ratzenböck
authors.forename: Peter
authors.initials: P
authors.lastname: Hartl
authors.forename: Herbert
authors.initials: H
authors.lastname: Lugmayr
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000601:surgery; D001317:Austria; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D003151:Community Health Centers / Q000706:statistics & numerical data; D057867:Endoleak / Q000209:etiology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome