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Ann Surg. 1995 Oct;222(4):449-65; discussion 465-9.

Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions.

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1
Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York, USA.

Abstract

OBJECTIVES:

Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients.

PATIENTS AND METHODS:

Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16[17%]), epidural (42[43%]), or general (38[40%]) anesthesia.

RESULTS:

Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98%. Immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%.

CONCLUSIONS:

This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction.

PMID:
7574926
PMCID:
PMC1234874
[Indexed for MEDLINE]
Free PMC Article
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