Endovascular treatment of abdominal aortic aneurysms: a review

Abdominal aortic aneurysm (AAA) is a relatively common disease among the elderly population and may be present in up to 5.9% of the population aged 80 years. Abdominal aortic aneurysm more than 5 cm in diameter are more prone to rupture, with a significant mortality rate. Conventional surgical treatment is quite effective in the lower surgical risk population; however, in the population with a higher risk level the mortality and morbidity significantly increase. The development of less invasive techniques to treat AAA derived from the necessity to reduce the morbidity and mortality. The development of the endovascular endoprostheses was a significant landmark in the management of those patients with AAA, particularly the ones with increased risk. Although the stent-graft technology is still in its infancy, a large amount of information is available and an attempt to summarize this experience is presented herein. An extensive review of the stent-graft technology is presented, including variations in design and classification of the several systems available. Technical aspects of the use of endovascular prostheses are presented, as well as the most recent outcome information available. The problems of endoleaks is discussed and the techniques for treatment and outcomes presented. Finally, a summary of specific information on most of the devices available is presented.