ABDOMINAL AORTIC-ANEURYSM TREATMENT - PRELIMINARY-RESULTS WITH THE TALENT STENT-GRAFT SYSTEM

PURPOSE: To evaluate the treatment of abdominal aortic aneurysm (AAA) with use of the endoluminal Talent stent-graft (TSG). PATIENTS AND MET HODS: In 10 men, AAA treatment was attempted with use of the TSG;, All patients presented significant surgical risk, with chronic obstructiv e pulmonary disease and coronary arteriopathy. The mean age was 65.5 y ears (range, 57-82 years), The mean proximal neck diameter was 25.8 mm (range, 21.6-34 mm), Five of the TSGs were straight tubes and five we re bifurcated systems, The main body of the TSG is made of a polyester graft material mounted on a self-expandable nitinol frame, The bifurc ated system uses polytetrafluoroethylene (PTFE) material for the legs and extensions mounted on a self-expandable nitinol frame, The bifurca ted grafts used a 22 to 27-F introducer and the extensions, a 18-F int roducer through a surgical cutdown technique. RESULTS: The TSG system was successfully implanted in nine patients and failed in one because of dislodgment after deployment, which required conversion to surgery. Four leaks occurred initially, One was sealed off with balloon dilati on at the end of the procedure, one leak was treated with an additiona l extension, another leak disappeared spontaneously in 30 days, and th e other leak required embolization 4 weeks after discharge, Seven pati ents were discharged on the third day after the procedure, and two pat ients were discharged at 1 and 2 weeks, respectively, Blood transfusio n was necessary in three patients because of hematoma at the incision site in two patients, which required surgical revision for hemostasis, and because of transoperative bleeding in one patient, Follow-up time ranged from 2 to 15 months. The only death occurred 5 days postoperat ively as a consequence of ischemic colitis and multisystem organ failu re in the only patient who required surgery. CONCLUSION: Treatment of AAA with the TSG system is effective for aneurysm exclusion. This devi ce seems to provide a good alternative to surgery in patients who are otherwise considered to be at high risk for complications after direct surgical repair, but it is not without risk of complications.