Outcome of abdominal aortic endografting in high-risk patients: a 4-year single-center study

To evaluate feasibility, safety, and effectiveness of endovascular abdominal aortic aneurysm (AAA) repair in patients whose fitness for surgery is questionable.

Between April 1997 and December 2001, 389 consecutive patients underwent endovascular AAA repair. Of these, 51 (13.1%) were ASA grade IV. The perioperative and late outcomes of this group were compared to the remaining 338 patients with ASA grades

Four (7.8%) perioperative deaths occurred in the ASA IV group compared to 1 (0.3%) in the ASA 0.05). Actuarial survival at 30 months was 62.9% in ASA IV group and 88.0% in ASA

Endovascular AAA repair in ASA IV patients is feasible and effective in preventing AAA rupture in the mid term. High-risk patients experience a worse prognosis than their good-risk counterparts. An individualized approach in selecting high-risk patients for endoluminal repair is mandatory.