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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2011 Dicembre;18(4):235-40
Endovascular repair of abdominal aortic aneurysm: personal experience
Janho K. E., Shishani J., Haboub H.
Royal Medical Services, Department of Vascular Surgery, King Hussein Medical Center, Amman, Jordan
Aim. Abdominal aortic aneurysm has a natural history of progressive growth and if untreated will eventually rupture with consequent high mortality. In this study, we present our experience in treating infrarenal abdominal aneurysms using endovascular stent grafts (EVAR).
Methods. A retrospective review of the records of 113 patients with infrarenal abdominal aortic aneurysms who were treated with endovascular stent grafts (EVAR) between January 2004 and July 2010 at King Hussein Medical Center and Queen Alia Military Hospital in Jordan was conducted. Eighty-five patients were males while 28 were females with a mean age of 71 years and an average aneurysm size of 60 mm. EVAR repair was performed in all patients with close follow up in respect to complication and mortality.
Results. One hundred and nine patients underwent elective repair for their abdominal aortic aneurysms with successful deployment of the endografts in all patients and no conversion to open surgical repair required. Aorto bi-iliac grafts were used in 103 patients while 5 patients had aorto uni iliac device and a straight graft was applied in one patient. A mean follow-up period of 24 months was carried out. Type I endoleak was reported in four patients, type II endoleak was described in 27 patients while type III leak was noticed in one case. Two patients had unilateral graft limb occlusion. Dissection with occlusion of the common femoral artery was diagnosed in 2 cases. Localized groin hematoma was demonstrated in 5 patients and superficial wound infection in 3 patients. The 30 day mortality was 1.8% while 16 patients died during long-term follow-up mostly due to non aneurysm related causes.
Conclusion. EVAR technology is continuing to develop and gaining acceptance as an alternative modality of treatment for abdominal aortic aneurysms. Still remain concerns about the long term data regarding durability of the repair and the necessity for reintervention and long-term follow-up.