ENDOVASCULAR TREATMENT OF ABDOMINAL AORTIC-ANEURYSMS

Abdominal aortic aneurysms (AAA) may now be treated by endovascular pl acement of an arterial graft. These grafts are inserted through the fe moral artery and then secured to the aorta above and below the aneurys m. The procedure reduces the risk of many perioperative complications and reduces hospital costs and length of stay. Several FDA-approved cl inical trials are currently in progress with a variety of different de vices. None is available for general use at this time. Overall, more t han 800 grafts have now been placed, with a primary success rate of gr eater than 80%. Several complications have been reported, but the inci dence of complications has generally decreased as proficiency has impr oved. The most troublesome problem has been leak of blood around the g raft with continued risk of aneurysm rupture; therefore, follow-up CT scans and clinical examinations are mandatory to allow for appropriate treatment. Future modifications of current devices and techniques for delivery can be expected to reduce the incidence of currently identif ied problems. Endovascular grafting for AAA offers important potential advantages over conventional repair and may become increasingly impor tant in the management of patients who have an abdominal aortic aneury sm.