Endovascular exclusion of abdominal aortic aneurysms - Initial experience with stent-grafts in cardiology practice

The use of an endovascular stent-graft prosthesis for the treatment of infr arenal abdominal aortic aneurysms is receiving increasing attention as an o ption that may avoid the significant morbidity and mortality associated wit h open surgical treatment. We studied the clinical effectiveness of stent-g rafts in patients with infrarenal abdominal aortic aneurysms. Between October 1995 and May 1998 33 patients underwent infrarenal abdomina l aortic aneurysm exclusion with a homemade polytetrafluoroethylene-covered stent, and between November 1998 and September 1999, 56 patients underwent abdominal aortic aneurysm exclusion with the Medtronic AneuRx stent-graft. Overall, these patients represented a high-risk surgical group. The techni cal success rate was 100% in both groups. No patient required immediate con version to open repair. With the polytetrafluoroethylene-covered stent, the primary success rate was 33%, and the secondary success rate was 76%. In t he AneuRx group, the primary success rate was 82.8%, and the secondary succ ess rate was 85.3% at 6 months. There was no procedural or I-month mortalit y or major morbidity in either group. By showing that infrarenal abdominal aortic aneurysms can be treated safely and successfully with an endoluminal stent-graft, our early results provid e additional support for the endovascular treatment of abdominal aortic ane urysms. Further follow-up studies will determine the long-term ability of s uch treatment to prevent aneurysmal rupture and death.