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J Vasc Surg. 2005 May;41(5):752-7.

Midterm outcome of endovascular repair of ruptured abdominal aortic aneurysms.

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1
Institute of Diagnostic Radiology, University Hospital of Zurich, CH 8091 Zurich, Switzerland.

Abstract

PURPOSE:

We sought to analyze the clinical and morphologic outcomes of bifurcated stent grafts in patients with ruptured aortoiliac aneurysms at midterm follow-up.

METHODS:

Thirty-seven patients (4 women; mean age, 73 years; mean abdominal aortic aneurysm [AAA] diameter, 77 mm) underwent endovascular abdominal aneurysm repair between June 1997 and July 2003 for ruptured AAA. Devices inserted were as follows: Vanguard (Boston Scientific, Natick, Mass; n = 7), Excluder (W.L. Gore, Flagstaff, Ariz; n = 25), Talent (Medtronic Vascular, Santa Rosa, Calif; n = 2), and Zenith (Cook Inc, Bloomington, Ind; n = 3). Except for the adjunct postimplantation computed tomographic scanning, the imaging follow-up was the same as for nonruptured AAAs.

RESULTS:

The mean follow-up period was 24 months (range, 1-59) months. Thirty-day mortality was 10.8%. Three patients died during the follow-up of non-AAA-related causes. One patient was converted early for presumed renal overstenting. The late conversion rate was 9% because of stent graft migration (n = 2) or infection (n = 1). Freedom from endoleak was 57% +/- 8.5% and 48.8% +/- 9% at 2 and 4 years, respectively. Seventeen secondary interventions were performed during the follow-up period, 41% of these within 1 month of stent graft placement. Endoleaks, primary or secondary, were responsible for 58.8% of these interventions. The cumulative risk of a secondary intervention was 35.3% +/- 9% at 2 years and 44.6% +/- 11% at 3 years. Aneurysmal sac shrinkage was observed in 30.8% +/- 9.1% and sac enlargement was observed in 15.3% +/- 10.8% at 2 years.

CONCLUSION:

Endoluminal devices are able to convert the acute life-threatening situation of ruptured AAA to a controlled situation that results in good patient survival at midterm follow-up.

PMID:
15886655
DOI:
10.1016/j.jvs.2005.02.023
[Indexed for MEDLINE]
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