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Lessons learned in adopting endovascular techniques for treating abdominal aortic aneurysm.
M A Patterson1, J M Jean-Claude, M R Crain
1Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|June 26, 2001
Summary
Endovascular aneurysm repair is a safe, feasible option for abdominal aortic and iliac aneurysms. Groin complications are the main cause of morbidity, necessitating long-term surveillance.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aneurysm Repair
Background:
- Traditional open repair of abdominal aortic aneurysms (AAA) carries significant risks.
- Endovascular aneurysm repair (EVAR) offers a less invasive alternative.
Purpose of the Study:
- To evaluate the safety and feasibility of endovascular exclusion for abdominal aortic and common iliac artery aneurysms.
- To compare short-term outcomes with traditional open repair.
Main Methods:
- Forty-one patients underwent EVAR for 39 AAAs and 2 iliac artery aneurysms.
- Successful device deployment was achieved in all cases.
- Procedure and hospitalization durations were recorded.
Main Results:
- The perioperative mortality rate was 2.4%.
- Groin wound complications occurred in 39% of patients, leading to prolonged hospitalization.
- Endoleaks were observed in 24% of patients, with most resolving spontaneously or requiring reintervention.
Conclusions:
- EVAR is a safe and feasible treatment for patients with large AAAs and cardiac comorbidities.
- Femoral groin complications represent the primary source of perioperative morbidity.
- Long-term surveillance is crucial to monitor for device migration and endoleaks, preventing potential rupture.