Document Detail


Talent LPS AAA stent graft: results of a pivotal clinical trial.
MedLine Citation:
PMID:  12663967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We report results of a pivotal prospective clinical trial that compared standard surgical repair with endovascular exclusion of abdominal aortic aneurysm (AAA) with the Talent LPS stent graft system. METHODS: Between March 24, 1999, and September 19, 2000, 240 patients with AAA who underwent stent graft placement and 126 patients who concurrently underwent surgery to treat AAA were enrolled at 17 centers in the United States. All patients were considered to be at low risk from aortic surgery. Patients who underwent endovascular repair received a bifurcated Talent LPS stent graft; surgical control subjects underwent standard operative techniques. Inclusion criteria were AAA larger than 4.0 cm in diameter, with proximal neck > 5 mm long and 14 to 32 mm in diameter, and a 15 mm landing zone in at least one common iliac artery. Access requirements included one external iliac artery of 7 mm caliber or larger. Preoperative anatomic evaluation included computed tomography and angiography. After stent-graft placement, evaluation involved plain radiography and computed tomography performed before discharge and at 1, 6, and 12 months and yearly thereafter. RESULTS: There was no significant difference in early (<30 days) or late mortality between the two groups. Complications were slightly higher in the surgical cohort. The stent graft group did better in terms of procedure duration, requirement for general anesthesia and blood transfusion, and intensive care unit and hospital stay. There were three access or deployment failures. Immediate surgical conversion was necessary in only 1 patient, and late conversion in 5 additional patients. There were no aneurysm ruptures. Endoleak rate detected at CT (core laboratory validated) was 14% at 1 month, 12% at 6 months, and 10% at 12 months. CONCLUSIONS: Compared with surgical control subjects, patients with AAA treated with the Talent LPS stent graft had fewer complications and the same low operative mortality. Likewise, endovascular repair performed better than surgery in the perioperative period, as measured with several key procedural indicators. Long-term follow-up of patients with the stent graft will be essential to assess durability of these early results.
Authors:
Frank J Criado; Ronald M Fairman; Gary J Becker;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  37     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-28     Completed Date:  2003-05-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  709-15     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Center for Vascular Intervention, Union Memorial Hospital/MedStar Health, Baltimore, MD 21218, USA. frank.criado@medstar.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Alloys / therapeutic use
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis* / adverse effects
Blood Vessel Prosthesis Implantation / adverse effects,  methods*,  mortality
Cohort Studies
Equipment Failure
Female
Humans
Male
Polymers / therapeutic use
Postoperative Complications
Prospective Studies
Stents* / adverse effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Alloys; 0/Polymers; 52013-44-2/nitinol

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


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