Endovascular Treatment of Infrarenal Aortic Aneurysm

pp 655-660

Abstract

Objective

To report the feasibility and efficacy of the infrarenal aortic aneurysm endovascular repair.

Material and method

From August 1998 to March 2000, we repaired 25asymptomatic aneurysms in 25 patients -all men, age 70.6 ± 7.8 years old (mean ± SD)- with bifurcated graft (Vanguard, Boston Scientific, USA, and Talent, Medtronic, USA). The procedures were taken under general anesthesia in 23 cases and with spinal anesthesia in the others.

Results

The surgical approach was successful in 96% (24patients) of the cases and only 1 conversion to an open repair was required. Minor complications occurred in two patients, one acute renal failure, non requiring dialysis, and one episode of chest pain. Follow up was performed along 260 ± 149days (mean ± SD). Two type 1 direct endoleaks were observed: one of the proximal that required an additional proximal extension, 3 months after the treatment and the other is under clinical control at present. One type 2 endoleak sealed with-out intervention. An early post-procedure death occured as well as two additional deaths non-related with the intervention were registered. We treated one limb occlusion with a femoral-femoral bypass. Primary success was achieved in 88% of  the population and secondary success was shown by 96% of the patients.

Conclusion

The endovascular aortic aneurysm repair seems to be an effective and safe method. A multidisciplinary approach and the proper selection of the patients are necessary to achieve success.