Endoluminal repair of abdominal aortic aneurysms - state of the art

This paper considers the historical aspects of endovascular aneursym repair ; the major findings of our Departments experience over an 8 1/2-year perio d and reviews recent developments in endovascular prostheses. Analysis of 4 00 patients undergoing primary repair of abdominal aortic aneurysm between 1992 and 2000 revealed a perioperative mortality rate of 2.7% and primary c onversion rate of 5%. With sequential studies it was shown that the outcome was better with bifurcated/aorto uni iliac grafts than tube grafts, better with second generation prostheses than first generation protheses and that survival in consecutive patients treated concurrently by open repair and e ndoluminal repair was superior in the endoluminal group. Endoluminal AAA re pair is at a critical point of its development. It is unquestioned that it can dramatically reduce the need for intensive care and length of hospital stay and more recently it has been reported that survival is improved compa red with open repair. The need for lifetime surveillance, the probability o f graft failure and need for re-intervention, however, negate some of the a dvantages. The small incidence of unpredictable rupture following endolumin al hAA repair is a timely reminder of the need for continued careful follow -up, (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.