Preliminary results of endovascular abdominal aortic aneurysm exclusion with the AneuRx stent-graft

OBJECTIVES This study evaluated the clinical effectiveness of the Medtronic AneuRx stent-graft in patients with infrarenal abdominal aortic aneurysms (AAAs) who were treated in an endovascular suite. BACKGROUND The use of endovascular stent-graft prosthesis for the treatment of AAAs is receiving increasing attention as an alternative to standard su rgical repair. Endovascular treatment of AAAs offers the potential to avoid the significant morbidity and mortality associated with surgical repair. METHODS In this series, 215 patients have undergone AAA exclusion with the AneuRx stent-graft. Six-month follow-up is available in 132 patients; one-y ear follow-up is available in 84 and two-year follow-up in 22. RESULTS Of the patients, one hundred ninety-two (89%) were male; 87% had hy pertension, and 58.6% were American Society of Anesthesiologists grade IV o r higher. The procedural success was 99.5%; we were una lc to place the, de vice in one patient. There was no procedural or one-month mortality. There were no acute conversions to surgical repair. One patient had a non-Q-wave myocardial infarction 24 h after the procedure. Endoleaks were present in 8 2 patients (42%) at discharge, 15 patients (11.3%) at six months and 10 pat ients (11.9%) at one year. Twenty-two patients had a secondary procedure fo r endoleak repair of which three, were conversions to surgical repair. Twel ve late deaths have occurred, none due to device failure or AAA,rupture. Me an hospital stay was 1.9 days. CONCLUSIONS These results reveal that infrarenal AAAs can be safely and suc cessfully treated in an endovascular suite with the AneuRx stent-graft. Fur ther follow-up is needed to determine the long-term efficacy of endoluminal treatment to prevent rupture and death due to AAAs. (C) 2001 by the Americ an College of Cardiology.