Bare metal stents with or without coil embolization for abdominal aortic aneurysm exclusion in high-risk patients

The objective of the study was to determine if uncovered self-expanding met allic stents with or without polyester-covered coils can exclude abdominal aortic aneurysms (AAA). Exclusion using uncovered metal stents with or with out coils has been shown to be successful in the animal model. Twelve patie nts underwent aneurysmal therapy with uncovered self-expanding metallic ste nts and polyester covered metallic coils (male, 8; female, 4; mean age, 74 +/- 8 years) because no other therapeutic alternative was available. Indica tions were severe aorto-iliac disease, presumptively high surgical risk due to comorbidities, a previously failed endograft attempt, and a hostile abd omen as a result of prior surgeries. Under local anesthesia, stents were in troduced percutaneously via 10 or 11 Fir sheaths into the femoral artery an d deployed in an overlapping fashion to cover the length of the AAA. All en doluminal procedures were successful, and no major complications were encou ntered. The average hospital stay was 33 +/- 21 hr. At a mean follow-up of 18 +/- 13 months, there was no rupture, leak, or evidence of aneurysm expan sion in any of the patients. There was one mortality that was not AAA-relat ed. The remaining patients had no aneurysm-related symptoms. Endoluminal ex clusion of an AAA using self-expanding bare metal stents with or without co il embolization may be a viable treatment option for patients who cannot un dergo standard surgical or endovascular repair. However, these data do not demonstrate that this methodology actually precludes rupture since the coho rt is of small size. (C) 2001 Wiley-Liss, Inc.