Endoluminal grafting of abdominal aortic aneurysms: experience with the Talent endoluminal stent graft

The aim of this study was to evaluate the Talent endoluminal stent graft (T ESG) in treating abdominal aortic aneurysms (AAA). The TESG is a polyester- covered nitinol endograft (proximal diameters 20-38 mm and iliac limb diame ters 8-22 mm). Twenty-two men were treated with the TESG via bilateral femo ral arteriotomies. Pre-implantation, coil embolization of various vessels a rising from the aneurysm was performed in 6 patients. Plain radiographs and spiral CT angiograms (CTA) were carried out at 7 days, 3, 6, and 12 months following TESG implantation or re-intervention. Median aortic and iliac di ameters were 27 mm (range 20-34 mm) and 14 mm (range 10-19 mm). The corresp onding graft diameters were 30 mm (range 24-38 mm) and 14 mm (range 12-20 m m). No patient was rejected purely on the basis of too large aortic or ilia c diameters. Eight patients required custom-made grafts. Graft implantation was successful in all patients. There were no blood transfusions, distal e mbolic episodes, or conversions to open surgery. Re-intervention was necess ary in 1 patient. Complications included one fatal myocardial infarction, o ne inguinal hematoma, and two superficial wound infections. The aneurysm th rombosed completely following implantation in 14 patients and at 3 or 6 mon ths in 4 other patients. One patient with endoleak is awaiting his 3-month control and 2 patients show tiny endoleaks but reduction of aneurysm size. The mean aneurysm size decreased significantly from 58 +/- 10 to 53 +/- 13 mm (p < 0.0005). Due to the large sizes available and the option of custom- made grafts, the TESG helps widen the spectrum of patients who can be treat ed with endoluminal grafting. The treatment is associated with a significan t reduction in aneurysm size.