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Endovascular stent graft repair of aortic aneurysms
1Instituto Cardiovascular de Buenos Aires, Argentina.
Insights
Endovascular repair offers a feasible alternative for patients with large aortic aneurysms and severe comorbidities, who are high-risk for open surgery. This minimally invasive approach demonstrated promising initial and late success rates in a cohort of 110 patients.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Treatment
Background:
- Older patients with large aortic aneurysms often have severe comorbidities.
- Conventional open aortic surgery carries a high risk of morbidity and mortality (>60%) in these patients.
- Many patients are prohibitive risks for traditional graft replacement.
Purpose of the Study:
- To evaluate the feasibility and outcomes of endoluminal repair for aortic aneurysms.
- To assess the efficacy of stent-graft devices in treating abdominal and thoracic aortic pathologies.
Main Methods:
- Endoluminal repair was performed on 110 patients using stent-graft devices.
- Procedures included aorto-aortic and aorto-iliac repairs for abdominal and thoracic aortic aneurysms.
- Devices were straight, tapered, or bifurcated, tailored to aortic pathology.
Main Results:
- Initial success rates were 84% for aorto-aortic abdominal devices and 100% for thoracic devices.
- Initial success for aorto-iliac devices was 75%.
- Late success rates were 62% of the total initial group and 80% of the initially successful group.
Conclusions:
- Endoluminal repair is a feasible alternative for high-risk patients with aortic aneurysms.
- Stent-graft technology provides a viable option for complex aortic pathologies.
- Minimally invasive endovascular techniques show potential for improving outcomes in challenging surgical cases.
Abstract:
Vascular surgeons are increasingly encountering older patients with large aneurysms associated with severe comorbid conditions. This situation can increase operative morbidity and elevate the mortality rate of aortic surgery over 60%. With some frequency many patients will represent a prohibitive risk for conventional graft replacement. The endoluminal treatment of 110 patients has proved to be feasible and may represent an alternative solution. One hundred six of the patients had an abdominal aortic aneurysm and in four patients, the thoracic aorta was involved. All of them underwent endoluminal repair for the aortic pathology using the combination of stents and grafts in aorto-aortic or aorto-iliac position, with straight, tapered, or bifurcated stent-graft devices. The results are as follows: Initial success was 84% in aorto-aortic abdominal devices and 100% in aorto-aortic thoracic devices. In aorto-iliac devices, initial success was 75%. Late success rates were 62% of the initial group and 80% of the initially successful group.