Document Detail

Five-year report of a multicenter controlled clinical trial of open versus endovascular treatment of abdominal aortic aneurysms.
MedLine Citation:
PMID:  17398057     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Compare long-term results of endovascular treatment and standard open repair of abdominal aortic aneurysms in a multicenter, concurrent-controlled trial.
METHODS: 334 subjects were treated with standard open repair (control, n = 99) or the original EXCLUDER Bifurcated Endoprosthesis (test, n = 235). Five-year clinical evaluations and corelab radiographic results are analyzed.
RESULTS: Overall and aneurysm-related survival are similar. There have been ten open conversions, most frequently for enlarging sacs without endoleak. Two patients died after conversion. Including reinterventions and complications of reinterventions as adverse events, there is significant, persistent long-term reduction in major adverse events. At 5 years, corelab reported 0% limb narrowing, 0% trunk migration, 0% component (contralateral leg, aortic extender, and iliac extender) migration, 0% fracture, endoleak in 3% (2 type II/68), and aneurysm growth (>5 mm compared to baseline) in 38% (30/78) of the test group. There are no aneurysm ruptures in either test or control group.
CONCLUSIONS: After 5 years follow-up, endovascular repair is a safer and effective treatment compared with open surgical repair for abdominal aortic aneurysms. Major adverse events are less frequent with the endograft despite the need for late reinterventions. Aneurysm expansion is observed in nearly two-fifths of patients but is not associated with endoleak or aneurysm rupture. Multicenter clinical trials are evaluating a newer version of this device designed to avoid this high rate of sac expansion.
Brian G Peterson; Jon S Matsumura; David C Brewster; Michel S Makaroun;
Related Documents :
16382267 - The effect of secondary operations on mortality following abdominal aortic aneurysm rep...
17605787 - Emergency endovascular repair of ruptured visceral artery aneurysms.
9279307 - Endovascular grafts for noninfected aortoiliac anastomotic aneurysms.
21819587 - Bullet embolization to the external iliac artery after gunshot injury to the abdominal ...
2799447 - Thyrocardiotoxic embolic syndrome.
24101797 - Relationship of the extent of pulmonary lesions to the partial pressure of oxygen and t...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-03-29
Journal Detail:
Title:  Journal of vascular surgery     Volume:  45     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-30     Completed Date:  2007-05-24     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  885-90     Citation Subset:  IM    
Saint Louis University, St. Louis, MO, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aortic Aneurysm, Abdominal / mortality,  surgery*
Blood Vessel Prosthesis Implantation*
Survival Analysis
Time Factors
Treatment Outcome
Comment In:
J Vasc Surg. 2007 Nov;46(5):1088-9; author reply 1089-90   [PMID:  17980304 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Total percutaneous access for endovascular aortic aneurysm repair ("Preclose" technique).
Next Document:  Cigarette smoking increases aortic dilatation without affecting matrix metalloproteinase-9 and -12 e...