EARLY EXPERIENCE WITH TRANSFEMORAL ENDOVASCULAR ANEURYSM MANAGEMENT (TEAM) IN THE TREATMENT OF AORTIC-ANEURYSMS

Objectives: To evaluate the early experience with transfemoral endovas cular aortic aneurysm management using the Endovascular Grafting Syste m.(TM) Design: Multi-centre prospective evaluation of the implantation procedure and early results (median follow-up 153 days). Setting: Dep artment of Surgery, University Hospital Utrecht, The Netherlands; Depa rtment of Surgery, University of Sydney, Australia; University of Leic ester School of Medicine, Leicester, U.K., Department of Surgery, Karo linska Hospital, Stockholm, Sweden and Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital; Oxford, U.K. Materials : 31 consecutive patients treated in 13 months. Chief outcome measurem ents: Peri and postoperative morbidity and mortality in accordance wit h the recommendations of the Ad Hoc Committee on Reporting Standards. Main results: Graft placement was initially successful in all 31 patie nts. In one patient the endograft had to be replaced by a standard aor tic tube graft because of extra graft flow in the aneurysm sac, and co mplaints of back pain. One patient died from multiple organ failure, 2 1 days after the operation. In three patients Jive severe adverse even ts were recorded. Breaks of the attachment system were encountered in two patients. These failures did not have severe clinical consequences for individual patients. Conclusions: Transfemoral Endovascular Aneur ysm Management is a technically demanding procedure that requires spec ial training in both catheter and surgical techniques. The potential f or less operative morbidity when compared to conventional surgery and the prospect of technical improvements in graft and introduction syste m design will make TEAM an important tool in aneurysm management in th e near future.