Document Detail


Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions.
MedLine Citation:
PMID:  7574926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M L Marin; F J Veith; J Cynamon; L A Sanchez; R T Lyon; B A Levine; C W Bakal; W D Suggs; K R Wengerter; S P Rivers
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of surgery     Volume:  222     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-11-22     Completed Date:  1995-11-22     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  449-65; discussion 465-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Aneurysm / radiography,  surgery
Aortic Aneurysm, Abdominal / radiography,  surgery
Arterial Occlusive Diseases / radiography,  surgery
Arteries / injuries
Blood Vessel Prosthesis*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Stents*
Vascular Patency
Vascular Surgical Procedures / methods
Grant Support
ID/Acronym/Agency:
HL 02990-02/HL/NHLBI NIH HHS
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