An update of the Zenith endovascular graft for abdominal aortic aneurysms:Initial implantation and mid-term follow-up data

Purpose: To evaluate the initial and mid-term results of the Zenith endovas cular grafting system for infrarenal abdominal aortic aneurysms. Methods: Prospective databases at seven centers were used to assess a cohor t of patients that underwent treatment for aortic, aortoiliac, or iliac ane urysms since 1995. Data were analyzed to yield descriptive characteristics that pertained to the patients, the aortic morphologic features, the graft configuration, and the complications. Follow-up imaging data were used to d etermine size changes of the aneurysm sac, endoleak rates, and further comp lications. Finally survival data were expressed with a Kaplan-Meier analysi s. Results: A total of 528 patients were treated with the Zenith endograft. Mo st of the patients (66%) were considered to be at a high physiologic risk f or open repair. Successful graft implantation was accomplished in all but f our patients. An overall endoleak rate of 15% was noted, of which 4% was tr eated urgently because they were thought to represent attachment site fault s. The mean follow-up period was 18 months. A total of eight endograft migr ations were detected after 2 years of follow-up with an early version of th e system. There were three late conversions; two ruptures occurred during t he follow-up period. Conclusion: This early and mid-term data support the use of the Zenith endo vascular graft for the treatment of aortic and aortoiliac aneurysms in prop erly selected patients. The risks of significant complications or aneurysm rupture are low.