ENDOLUMINAL REPAIR OF LARGE ABDOMINAL AORTIC-ANEURYSMS USING PTFE - AFEASIBILITY STUDY

Purpose: To investigate the feasibility of using predilated thin-wall polytetrafluoroethylene (PTFE) secured by extra-large Palmaz stents fo r endoluminal repair of abdominal aortic aneurysms (AAA). Methods: Thi rty-two patients (26 males; aged 69 to 83 years) from three centers (t wo in Europe, one in Australia) were selected for endoluminal stent-gr afting using predilated 8-mm PTFE graft material fitted with extra-lar ge Palmaz stents al the terminal ends. Aortoaortic tube grafts were im planted in 12 patients, while the remainder received aortomonoiliac en dografts and femorofemoral bypass. Follow-up at 5 days and then biannu ally was by contrast-enhanced computed tomography (CT) or duplex scann ing. Results: There were 13 conversions to open surgery; three patient s died within 30 days. Nineteen patients were discharged with function ing endografts within 5 days of treatment. Of these, two have had thei r grafts removed owing to infection in one and distal stent migration in the other. Two endoleaks have been detected in follow-up; one has b een sealed by covered stenting. One twisted graft was repaired by Wall stent implantation. Seventeen patients remain well, one with persisten t distal endoleak, but none shows an increase in AAA diameter on imagi ng over the 6- to 26-month (median 13) follow-up. Conclusions: These r esults represent the learning curves of th ree separate centers. Techn ical failure and complications were more common early in the study. Ad vantages of the technique include relative low cost and the ability to tailor the stent-graft to the individual aneurysm.