Document Detail


Lessons learned in adopting endovascular techniques for treating abdominal aortic aneurysm.
MedLine Citation:
PMID:  11386998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Endovascular exclusion of abdominal aortic and common iliac aneurysms can be performed safely, and in the short term represents a feasible alternative to traditional, open aneurysm repair. PATIENTS AND METHODS: Forty-one patients were treated with endovascular grafts for 39 abdominal aortic and 2 common iliac artery aneurysms. RESULTS: All devices were successfully deployed. The size of the abdominal aortic aneurysms varied from 4.9 to 11.9 cm (average, 6.13 cm). The median procedure time was 195 minutes. There was one iliac artery rupture, which required celiotomy for repair. The hospital stay varied from 2 to 39 days (average, 6.7 days). The perioperative mortality rate was 2.4%. Sixteen patients (39%) had groin wound complications. Ten patients (24%) had evidence of contrast (endoleak) within the aneurysm sac on completion of the procedure. There were no obvious direct leaks from either the point of proximal or distal fixation. Seven of these endoleaks have resolved spontaneously. Two patients required additional procedures in the postoperative period to treat endoleak. The final patient has evidence of persistent endoleak on 3-month surveillance computed tomography scan. Major late problems occurred in 3 patients. CONCLUSION: Patients with large abdominal aortic aneurysms and considerable cardiac comorbidity can safely undergo endovascular aneurysm repair. Femoral groin wound complications resulting in prolonged hospitalization remain the major cause of perioperative morbidity. In contradistinction to open aneurysm repair, long-term surveillance is essential to detect migration of the device and identify flow within the residual aneurysm sac-complications that could lead to aneurysm rupture following endovascular repair.
Authors:
M A Patterson; J M Jean-Claude; M R Crain; G R Seabrook; R A Cambria; W S Rilling; J B Towne
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  136     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-06-01     Completed Date:  2001-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-34     Citation Subset:  AIM; IM    
Affiliation:
Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty / adverse effects,  instrumentation*,  methods*,  mortality
Aortic Aneurysm, Abdominal / complications,  radiography,  surgery*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  methods*,  mortality
Comorbidity
Coronary Disease / complications
Equipment Design
Female
Humans
Hypertension / complications
Iliac Aneurysm / complications,  radiography,  surgery*
Length of Stay / statistics & numerical data
Male
Middle Aged
Prospective Studies
Retrospective Studies
Stents*
Time Factors
Tomography, X-Ray Computed
Treatment Outcome

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


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