Endovascular treatment of aortic aneurysm using the Chuter device

This article assesses a system of endovascular aneurysm repair and determin es its potential role in the management of abdominal aortic aneurysm (AAA). The prosthesis was a combination of woven polyester fabric and stainless s teel Gianturco Z-stents. Straight (aorto-aortic), tapered (aorto-uniiliac), and bifurcated (aorto-biiliac) stent grafts have all evolved, together wit h the delivery systems, the patient selection criteria, and the method of i nsertion, since these devices were first introduced in 1991. Currently, 70% of patients are considered to have the anatomic substrate for endovascular aneurysm repair. All stent-graft implantations were performed in the opera ting room. Preoperative assessment and postoperative follow-up were based m ainly on contrast- enhanced CT, which was performed at 3 days, 3 months, 6 months, and 12 months following repair, if the initial CT showed endoleak, CT was repeated at 2 weeks. Persistent leak at 2 weeks was investigated ang iographically as the basis for endovascular intervention, following which C T was repeated again. The results of the most recent (US) experience are as follows. Between June 1996 and September 1997, 46 high-risk patients under went elective endovascular repair of AAA under an FDA protocol. Aorto-uniil iac stent grafts were used in 38 and aorto-aortic stent grafts in the remai nder. The operating time was 190 +/- 71 min (mean + standard deviation), es timated blood loss was 303 +/- 402 ml, and contrast volume was 153 +/- 70 m l. The time from operation to resumption of a normal diet was 0.58 +/- 0.58 days, to ambulation was 1.17 +/- 0.8 days, and to discharge was 3.42 +/- 1 .51 days. Six patients had an endoleak on the initial CT, but only 1 of the se had leakage 1 month after operation. There were no deaths and no convers ions to open repair. Endovascular aneurysm re pair with this system is safe and effective in the short to medium term.