[Endovascular treatment of abdominal aortic aneurysms]

The endovascular method of treating abdominal aortic aneurysms was introduced as an alternative to conventional surgical repair in the hope of reducing the operative mortality and morbidity.

Thirty patients were selected for endovascular aneurysm repair on the basis of anatomical criteria. The result of the treatment was evaluated by angiography on completion of surgery and by contrast-enhanced CT scans at 1, 3, 6, and 12 months, and annually thereafter.

Exclusion of the aneurysm sac was achieved in 27 patients. Acute conversion to open surgical repair was necessary in one patient, owing to arterial damage. Two patients had primary endoleak. In one patient the endoleak disappeared spontaneously, in the second patient conversion to open repair was performed during follow up. The operative mortality was 0%, and the incidence of early complications requiring treatment was 13%. During a median follow-up period of 22 months, secondary endoleaks were detected in five patients and graft-limb occlusion occurred in three patients. Secondary intervention was performed in eight patients (29%).

In selected patients, endovascular repair is feasible and associated with few major perioperative complications. The observed rate of secondary intervention emphasises the need for continued surveillance.