The Endovascular Technologies Endograft: Single-Center Experience over a Three-Year Period

Abstract

This article investigates the results of endovascular aneurysm repair with the Endovascular Technologies Tube and Bifurcated Endograft. During a three year period, 30 patients were operated on as part of an FDA-supervised international trial. A tube graft was inserted in 17 cases and a bifurcated graft in 13. All patients were treated in the operating theater, using a mobile fluoroscopy arm. Successful cases were subjected to a follow-up regime of repeated physical and radiological exams. The endograft could be inserted in 27 patients (90%). In two cases the graft could not be advanced due to severe calcification of the iliac arteries. In one patient, inadequate distal positioning of a tube graft could not be corrected by endovascular techniques. One patient died (3%) due to a proximal aortic tear. Except abdominal wound dehiscence in a converted patient, no serious postoperative complications were seen. Endoleak was encountered in 11 patients (37%), resulting in conversion in five (17%). The success rate at a median follow-up of 12 months was 70%; however, 6 out of 8 technical failures occurred in the first 15 patients. This study demonstrated a learning curve in endovascular aneurysm repair. Arrest of growth or shrinkage of the aneurysm was seen in all patients with a completely thrombosed aneurysm sac. No evidence of graft migration, infection, or thrombosis was found in this series during follow-up.

Keywords:

Endovascular aneurysm repair - endograft - abdominal aortic aneurysm - endoleak