ENDOVASCULAR GRAFTS FOR NONINFECTED AORTOILIAC ANASTOMOTIC ANEURYSMS

Purpose: This report describes our experience with endovascular repair of aortic and iliac anastomotic aneurysms. Methods: Between June 1994 and March 1996, 12 noninfected aortic or iliac anastomotic aneurysms in 10 patients who had serious comorbid medical conditions that preclu ded or made difficult standard operative repair were treated using end ovascular grafts. No patient in this study had a history of fever leuk ocytosis, or computed tomographic evidence of a periprosthetic fluid c ollection that was suggestive of infection of the original graft. Endo vascular grafts composed of polytetrafluoroethylene and balloon-expand able stents were introduced through a femoral arteriotomy and were pla ced using over-the-wire techniques under C-arm fluoroscopic guidance. Results: Endovascular grafts were successfully inserted in all patient s with aortic or iliac anastomotic aneurysms. There were no procedure- related deaths, and complications included one postprocedure wound hem atoma and one perioperative myocardial infarction. Graft patency has b een maintained for a mean of 16.1 months, with no computed tomographic evidence of aneurysmal enlargement or perigraft leakage. Conclusions: Endovascular grafts appear to be a safe and effective technique for e xcluding some noninfected aortoiliac anastomotic aneurysms in high ris k patients and may become a treatment option in all patients who have clinically significant lesions.