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Six-year experience with talent stent-graft repair of abdominal aortic aneurysms
Gaudencio Espinosa1, Márcia Ribeiro, Cristina Riguetti
1Department of Vascular Surgery, University Hospital, Federal University of Rio de Janeiro, Brazil. g.espinosa@uol.com.br
Insights
The Talent Endoprosthesis demonstrated efficacy in treating abdominal aortic aneurysms (AAA), showing good long-term outcomes and no material fatigue over six years. This stent-graft offers an efficient alternative for AAA management with acceptable morbidity and mortality.
Area of Science:
- Vascular Surgery
- Medical Devices
- Endovascular Repair
Background:
- Abdominal aortic aneurysm (AAA) poses a significant health risk.
- Endovascular aneurysm repair (EVAR) offers a minimally invasive treatment option.
- Long-term data on specific stent-grafts are crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the long-term performance and clinical outcomes of the Talent Endoprosthesis in AAA treatment.
- To assess the durability and safety of the Talent Endoprosthesis over a 6-year follow-up period.
Main Methods:
- A cohort of 193 patients with AAA were treated with the Talent Endoprosthesis between 1997 and 2003.
- Patients underwent clinical and radiological follow-up for up to 72 months, including annual computed tomography scans and plain abdominal radiograms.
- Implantation success, endoleak rates, perioperative and late mortality, and aneurysm sac behavior were assessed.
Main Results:
- Successful implantation was achieved in 99.0% of patients.
- The 6-year follow-up showed no signs of material fatigue in the Talent Endoprosthesis, though one component disconnection occurred.
- A significant average reduction in aneurysm diameter was observed, reaching 14.1+/-10.7 mm after 60 months.
Conclusions:
- The Talent Endoprosthesis proved to be an efficient treatment for AAAs, yielding low morbidity and mortality.
- The device demonstrated good long-term clinical outcomes and durability without material fatigue over a 6-year period.
- This study supports the Talent Endoprosthesis as a viable option for managing abdominal aortic aneurysms.
Purpose:
To report a long-term experience with the Talent Endoprosthesis for the treatment of abdominal aortic aneurysm (AAA).
Methods:
In the period between June 1997 and June 2003, 193 patients (171 men; mean age 71.0+/-7.8 years, range 52-89) with AAA were treated with a Talent Endoprosthesis. Patients were clinically and radiologically followed in the postoperative period, at 30 days, and then annually up to 72 months. In addition to computed tomographic scans, a plain abdominal radiogram was also performed annually for structural assessment of the stent-graft.
Results:
Implantation success was 99.0% (191/193). Delivery system introduction was the cause of 1 failure, and the other patient was converted to surgery for intraprocedural device migration. There were 10 (5.2%) endoleaks (3 type I, 7 type II) at 30 days; all type I and 3/7 type II endoleaks were treated (93.3% secondary clinical success). Seven (3.7%) patients died in the perioperative period, including the conversion. During follow-up, 18 (9.3%) additional deaths occurred, and 4 new endoleaks (1 type I, 2 type II, 1 type III) were encountered. In up to 6 years' follow-up, the Talent Endoprosthesis did not present signs of material fatigue, but 1 component disconnection at 42 months led to death. There was no aneurysm rupture. After an initial increase in the aortic neck (1.2+/-1.1 mm) in the postoperative period, the neck diameters continued to increase until after the third year. An average reduction of 5.6+/-4.1 mm in the aneurysm diameter at 1 year was noted; the reduction gradually reached 14.1+/-10.7 mm after 60 months.
Conclusions:
The Talent Endoprosthesis was an efficient alternative for managing AAAs, achieving low morbidity and mortality rates and a good long-term clinical outcome in this study. The Talent Endoprosthesis did not present signs of material fatigue over a 6-year follow-up.
