Endovascular treatment of abdominal aortic aneurysms

Objective: The purpose of this paper is to briefly review the historical as pects and outcome of endoluminal abdominal aortic aneurysm (AAA) repair and summarise two studies presented at the 1997 and 1998 meetings of the Socie ty for Vascular Surgery. Patients: Between May 1992 and September 1998 the endoluminal method was used to repair arterial aneurysms in 304 patients at the Royal Prince Alfred Hospital, Sydney, a tertiary referral teaching hos pital, The study focuses on 243 patients with true AAA who underwent primar y repair. There were 17 females and 226 males with a mean age of 72 years. Co-morbidities leading to rejection for conventional open repair were prese nt in 83 patients. The criteria for inclusion included a segment of thrombu s-free aorta between the lowermost renal artery and the commencement of the aneurysm of 1.5 cm or greater and iliac arteries that allowed access to th e aorta from the groin. The technique involved the delivery of an endograft into the abdominal aorta by means of a sheath inserted through the femoral or iliac artery, Laparotomy associated with conventional open repair was a voided. Outcome measures included clinical examination and contrast-enhance d computed tomography (CT) within 10 days, at 6, 12, 18 months after operat ion and then annually thereafter. Results: Endografts were successfully dep loyed in 226 patients. In the remaining 17 patients endoluminal repair was converted to open repair. There were 8 deaths within 30 days of operation g iving a perioperative mortality rate of 3.3%. The two studies presented to the Society for Vascular Surgery concern: (i) a concurrent comparison of th e endoluminal versus open methods of treating AAA; and (ii) a comparison of adverse events following endoluminal repair of AAA during two consecutive periods of time. (C) 1999 The International Society for Cardiovascular Surg ery. Published by Elsevier Science Ltd. All rights reserved.