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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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REVIEW AN UPDATE ON AVAILABLE STENTS FOR THE MANAGEMENT OF ABDOMINAL AORTIC ANEURYSMS
The Journal of Cardiovascular Surgery 2009 Aprile;50(2):159-64
Results of endovascular abdominal aortic aneurysm repair with selective use of the Gore Excluder
Bos W. T. G. J. 1, Tielliu I. F. J. 1, Van Den Dungen J. J. A. M. 1, Zeebregts C. J. 1, Sondakh A. O. 1, Prins T. R. 2, Verhoeven E. L. G. 1
1 Department of Surgery, Division of Vascular Surgery University Medical Center Groningen Groningen, The Netherlands
2 Department of Surgery, Division of Radiology University Medical Center Groningen Groningen, The Netherlands
Aim. To evaluate single center results with selective use of the Gore Excluder stent-graft for elective abdominal aortic aneurysm repair.
Methods. Retrospective analysis of a prospective data base. Primary endpoints were technical success, all-cause and aneurysm-related mortality and aneurysm rupture. Secondary endpoints were late complications including migration, endoleak, aneurysm growth, limb occlusion, and re-intervention.
Results. The Gore Excluder stent-graft was used in 92 elective cases, mainly in cases with difficult iliac anatomy. There were 81 (88%) male patients. Mean age was 70.4±7.5 (range, 53-87). Primary assisted technical success rate was 98.9% (91/92 patients). Thirty-day mortality was 0%. Median follow-up was 35.7 months (range, 2-99). Overall survival was 95.2±2.4% at 1 year, 89.2±3.7% at 2 years, 83.9±4.5% at 3 years and 70.2±6.8% at 5 years. During follow-up there were 3 (3.3%) Type I endoleaks and 20 (21.7%) Type II endoleaks. Proximal migration of more than 5 mm without endoleak occurred in two patients. In total 13 re-interventions were performed in 12 (13%) patients. No graft limb occlusion occurred. No aneurysm ruptured during follow-up.
Conclusion. Selective use of the Gore Excluder demonstrates excellent short- and long-term results. Despite being used in challenging iliac anatomy no graft limbs occluded.