Endovascular repair of abdominal aortic aneurysm: an initial experience

Endovascular repair of abdominal aortic aneurysm (AAA) was attempted in ten patients over a 12-month period. Median age was 72 (range 61-82) years and median AAA diameter was 5.5 (range 5.2-6.0) cm. An aortoaortic (tube) graft was used in seven patients and a tapered aortoiliac reconstruction in three. There were two failures requiring conversion to open repair. Additional procedures included iliac artery angioplasty (two), coil embolization of an associated common iliac aneurysm (one) and femorodistal bypass (one). Median operating time was 162 (range 95-270) min and median blood loss was 1200 (range 800-2000) ml. Median hospital stay was 9 (range 5-21) days. Complications included death (one), reversible acute tubular necrosis (one) and prolonged ventilation (one). Postoperative evaluation with duplex ultrasonography and computed tomography demonstrated three perigraft leaks (two proximal and one distal). It is concluded that endovascular repair of AAA is feasible but is associated with significant complications and requires careful evaluation before widespread use.