Abdominal aortic aneurysm in high-risk patients: Short- to intermediate-term results of endovascular repair

PURPOSE: To assess the safety and efficacy of endovascular repair of abdomi nal aortic aneurysm in high-risk patients during the short to intermediate term. MATERIALS AND METHODS: Endovascular aneurysm repair was performed in 50 pat ients considered too high risk for conventional repair. Stent-grafts were i nserted through surgically exposed femoral arteries with fluoroscopic guida nce. The anesthetic technique was epidural in 36 patients, general in 12, a nd local in two. Aortuniiliac stent-grafts were inserted in 42 patients and aortoaortic in eight. RESULTS: There were no deaths and no conversions to open surgical repair. T he primary success rate (complete aneurysm exclusion according to CT criter ia) was 88% (44 of 50). The secondary, clinical, and continuing success rat es were all 98% (49 of 50). Surgical time was 196 minutes +/- 67 (mean +/- SD), blood loss was 284 mL +/- 386, and volume of contrast material adminis tered was 153 mL +/- 64. The time from the end of the surgery to resumption of a normal diet was 0.58 days +/- 0.56, to ambulation was 1.22 days +/- 0 .77, and to discharge from the hospital was 3.63 days +/- 1.60, Wound probl ems accounted for the majority of complications. There were no instances of pulmonary failure, renal failure, stent-graft migration, or late leakage, CONCLUSION: Endovascular repair of abdominal aortic aneurysm is feasible in two-thirds of high-risk patients, with a low mortality and high success ra te during the short to intermediate term.