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[Intermediate-term complications and problems after endovascular aortic stent prostheses]
T Umscheid1, W J Stelter, P Ziegler
1Chirurgische Klinik, Städtische Klinik Frankfurt-Höchst, Frankfurt/M.
Zentralblatt Fur Chirurgie
|March 7, 2000
Summary
Endovascular stentgrafts for aortic aneurysm exclusion showed a 91% primary exclusion rate but concerning midterm complications. Newer grafts offer improved features, suggesting potential for better long-term outcomes in aortic repair.
Area of Science:
- Vascular Surgery
- Medical Device Technology
- Aortic Disease Management
Background:
- Endovascular stentgrafts have emerged as an alternative to conventional open repair for aortic aneurysms.
- Early experiences with commercially available stentgrafts presented challenges and limitations.
Purpose of the Study:
- To evaluate the midterm outcomes of endovascular stentgraft treatment for aortic aneurysm exclusion.
- To identify common midterm complications associated with early stentgraft designs.
Main Methods:
- Retrospective analysis of 321 patients treated with endovascular stentgrafts between August 1994 and December 1998.
- Assessment of primary exclusion rates, leakage, mortality, and midterm complications.
Main Results:
- A primary exclusion rate of 91% was achieved, with 8.7% primary leakage and 3.7% hospital mortality.
- Common midterm complications included secondary endoleaks (60 cases) and graft limb occlusion (37 occurrences).
- 50% of secondary endoleaks and most graft limb occlusions were treated, with varying success.
Conclusions:
- Midterm results of early commercially available endografts for aortic aneurysm repair are not yet satisfactory compared to conventional methods.
- Recent advancements in graft design, including improved kink resistance and reduced modularity, show promise for enhanced durability and reduced complications.