ENDOVASCULAR TREATMENT OF ABDOMINAL-AORTA ANEURYSMS WITH BIFURCATED ENDOPROSTHESIS

Objective. To obtain an initial assessment of the implantation techniq ue of bifurcated vascular endoprothesis in the treatment of abdominal aorta aneurysms (AAA). Methods. Eleven Vanguard type endoprostheses we re implanted in eleven patients with infra-renal aortic aneurysm. The technique was performed with surgical approach in one femoral artery, and percutaneously in the other. The procedure was performed with epid ural anesthesia. Results. A technical success -i.e., the exclusion of the aneurysm-was obtained in all cases. No technical complications occ urred during the procedure. Three patients had low degree contrast lea k in the angiographic control immediately after the procedure. Eight p atients had low grade fever in the immediate follow-up which resolved with medical therapy, two patients had hematomas in the approach sites , one renal infarction, one ileus for two days, another one for five d ays, and three patients had lymphatic effusion. During follow-up the p atients with leak had to undergo co-axial endoprosthesis implantation. Conclusions. It is our view that bifurcated vascular endoprostheses o ffer a valid alternative in the treatment of AAA. The procedure can be performed with epidural anesthesia and sedation, with a low rate of c omplications. The long term follow-up and the perfectioning of the app roach and resection systems will ultimately dictate their usefulness i n this and other vascular conditions.