CLINICAL STUDY
Preliminary results of endovascular abdominal aortic aneurysm exclusion with the AneuRx stent-graft
Marcus H. Howell, MD*,
Neil Strickman, MD, FACC*,
Ali Mortazavi, MD, FACC*,
Charles H. Hallman, MD and
Zvonimir Krajcer, MD, FACC*
* Department of Cardiology, Houston, Texas, USA
Department of Cardiovascular Surgery, Texas Heart Institute/St. Luke’s Episcopal Hospital, Houston, Texas, USA
Manuscript received July 13, 2000;
revised manuscript received May 7, 2001,
accepted June 19, 2001.
Reprint requests and correspondence: Dr. Zvonimir Krajcer, 6624 Fannin, Suite 2780, Houston, Texas 77030
leachman{at}ix.netcom.com
OBJECTIVES
This study evaluated the clinical effectiveness of the Medtronic AneuRx stent-graft in patients with infrarenal abdominal aortic aneurysms (AAAs) who were treated in an endovascular suite.
BACKGROUND
The use of endovascular stent-graft prosthesis for the treatment of AAAs is receiving increasing attention as an alternative to standard surgical repair. Endovascular treatment of AAAs offers the potential to avoid the significant morbidity and mortality associated with surgical repair.
METHODS
In this series, 215 patients have undergone AAA exclusion with the AneuRx stent-graft. Six-month follow-up is available in 132 patients; one-year follow-up is available in 84 and two-year follow-up in 22.
RESULTS
Of the patients, one hundred ninety-two (89%) were male; 87% had hypertension, and 58.6% were American Society of Anesthesiologists grade IV or higher. The procedural success was 99.5%; we were unable to place the device in one patient. There was no procedural or one-month mortality. There were no acute conversions to surgical repair. One patient had a non–Q-wave myocardial infarction 24 h after the procedure. Endoleaks were present in 82 patients (42%) at discharge, 15 patients (11.3%) at six months and 10 patients (11.9%) at one year. Twenty-two patients had a secondary procedure for endoleak repair of which three were conversions to surgical repair. Twelve late deaths have occurred, none due to device failure or AAA rupture. Mean hospital stay was 1.9 days.
CONCLUSIONS
These results reveal that infrarenal AAAs can be safely and successfully treated in an endovascular suite with the AneuRx stent-graft. Further follow-up is needed to determine the long-term efficacy of endoluminal treatment to prevent rupture and death due to AAAs.
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Abbreviations and Acronyms
| | AAA | = abdominal aortic aneurysm | | CHF | = congestive heart failure | | CT | = computed tomography | | ICU | = intensive care unit |
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