Endovascular repair of abdominal aortic aneurysms and other arterial lesions

The diagnosis of abdominal aortic aneurysm (AAA) has been established with increasing frequency during the past two decades. Although AAA may cause distal embolization, rupture remains the most common and deadly complication. For nearly 40 years, elective replacement with a synthetic graft has proved to be the most appropriate method to prevent AAA rupture, and it has been associated with a postoperative mortality rate of less than 5% at most medical centers. Nonfatal complications occur with some regularity, irrespective of the setting in which the operation is performed. Increasingly, vascular surgeons are encountering older patients with severe comorbid medical conditions that can increase operative morbidity and may significantly elevate mortality. This, in turn, can increase operative morbidity and may significantly elevate mortality for aortic surgery. An alternative form of treatment such as induction of aneurysm thrombosis generally has been abandoned despite preliminary reports ofinitial success.