Custom bifurcated stent-graft for abdominal aortic aneurysms: Initial experience

PURPOSE: To describe a custom bifurcated stent-graft for possible treatment of abdominal aortic aneurysm (AAA), MATERIALS AND METHODS: Five male patients (mean age, 76 +/- 6 years), who h ad AAA (mean diameter, 4.7 +/- 0.4 cm) and who were considered to be at hig h risk for conventional surgery, were treated with a custom medullar bifurc ated stent-graft constructed with bifurcated 24-mm x 12-mm (upper body diam eter x iliac limb diameter) Cooley Veri-Soft Woven polyester grafts and Gia nturco-Rosch Z stents, The stent-graft body was delivered through 20-22-F s heaths, and the contralateral iliac limb was delivered through a 16-F sheat h by means of surgical exposure of the common femoral arteries. A flared di stal limb extender (12 mm to 14 mm) was created for one patient to accommod ate a large common iliac artery. RESULTS: Stent-grafts were successfully deployed without complications in a ll five patients. There were no proximal or distal leaks. A lumbar-to-infer ior mesenteric artery leak was seen in one patient at 24 hours. At B-month follow-up, all devices were intact, with complete exclusion and shrinkage o f the aneurysm in four of five patients. Aneurysm size remained stable in t he one patient with a lumbar-to-inferior mesenteric artery leak. CONCLUSION: A custom, bifurcated stent-graft was utilized for endovascular treatment of AAA, Long-term follow-up is necessary for the device.