ASSESSMENT OF FEASIBILITY FOR ENDOVASCULAR PROSTHETIC TUBE CORRECTIONOF AORTIC-ANEURYSM

Abdominal aortic aneurysm (AAA) can now be corrected by perfemoral int roduction of a prosthetic tube graft with fixation using expandable me tal stents. This technique requires a satisfactory iliac system, throu gh which the graft can reach its destination, and suitable lengths of non-aneurysmal aorta below the renal arteries and above the aortic bif urcation for stent attachment. The feasibility for placement of endova scular grafts was assessed in 44 consecutive patients admitted for tra nsabdominal AAA repair. The proximal and distal aneurysmal necks and t he iliac arteries were assessed before operation by colour flow Dopple r ultrasonography (duplex scanning), computed tomography and intraveno us digital subtraction angiography, using intraoperative measurements as the 'gold standard'. At operation 32 of 44 patients had a suitable proximal neck and five of 44 a suitable distal neck for endovascular g rafting. Duplex scanning was the most accurate modality for preoperati ve assessment of the aneurysm necks. According to this technique 32 of 44 patients had a satisfactory iliac system for introduction of an en dovascular graft. Overall only four of 44 patients were considered sui table for endovascular correction of AAA using a tube graft-stent comb ination.