ORIGINAL ARTICLES   

Giornale Italiano di Chirurgia Vascolare 1999 March;6(1):23-33

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English, Italian

Endovascular treatment of infrarenal abdominal aortic aneurysm using modular endovascular grafts. Personal experience

Biasi G. M., Piglionica M. R., Meregaglia D., Ferrari S. A.

From the Department of Vascular Surgery * Radiological Unit University of Milan, Italy Ospedale Bassini, Cinisello Balsamo (MI), Italy

Aim and back­ground. The aim of ­this ­study was to eval­u­ate the ear­ly and ­late ­results in a ­series of ­patients ­with abdom­i­nal aor­tic aneu­rysms under­go­ing endo­vas­cu­lar treat­ment ­using a trans­fe­mo­ral ­approach, ­with implan­ta­tion of mod­ular bifur­cat­ed Medtronic/AneuRx endo­vas­cu­lar ­grafts.
Methods. Between January 1997 and March 1998, at the Department of Vascular Surgery of the University of Milan – Ospedale Bassini in Cinisello B., a ­total of 22 Medtronic/AneuRx endo­vas­cu­lar ­grafts ­were implant­ed dur­ing the treat­ment of infra­ren­al abdom­i­nal aor­tic aneu­rysms ­with a ­mean diam­e­ter of 50 mm (­range 35-67). The ­mean age of the 23 ­patients (21 ­males and 2 ­females) was 73 ­years (59-86). The ­mean oper­at­ing ­time was 173 min­utes (120-240) ­with a ­mean ­blood ­loss of 765 ml (100-2000). All ­patients under­went con­trol CT at 72 ­hours, 6 and 12 ­months ­after sur­gery.
Results. No ear­ly or ­late com­pli­ca­tions are report­ed in 20 ­patients ­with cor­rect implan­ta­tion of the endo­vas­cu­lar ­graft and com­plete exclu­sion of the aneu­rysm. The ­only ­death in ­this ­series was not cor­re­lat­ed to the ­graft. Complications includ­ed a mas­sive embol­isa­tion ­with ampu­ta­tion at the ­thigh and one ­case of con­ver­sion to ­open sur­gery. Three cas­es of endo­leaks are ­still ­being mon­i­tored.
Conclusions. The pre­lim­i­nary ­results ­obtained by ­this cen­tre ­using the mod­ular Medtronic/AneuRx endo­vas­cu­lar ­graft ­system ­have ­been sat­is­fac­to­ry. The flex­ibil­ity and mod­ular­ity of the ­system ­enable it to be ­used in a ­large num­ber of cas­es of abdom­i­nal aor­tic aneu­rysm, ­with accept­able com­pli­ca­tion ­rates. The ­authors ­affirm ­that ­this ­system is a val­id alter­na­tive to tra­di­tion­al sur­gery for abdom­i­nal aor­tic sur­gery.