Endoluminal treatment of abdominal aortic aneurysms

Background: We report our preliminary results with endovascular treatment of abdominal aortic aneurysms (AAA). Methods: Between October 1998 and June 2000, 64 patients (62 male, two female; mean age = 70 years) underwent endovascular repair of AAA. Different types of prostheses were used, both bifurcated (n = 58) and straight (n = 6). We performed duplex sonography and spiral computed tomographic angiography (CTA) at discharge and at 3, 6, 12, and 18 months. Follow-up ranged from 1 to 20 months. Results: All procedures were successful, except for three immediate and one late surgical conversions (6.2%). One patient died 14 days after immediate surgical conversion. At discharge, CTA showed 13 endoleaks: three resolved spontaneously, six persisted during follow-up, and four (one angioplasty and three embolizations) were treated successfully. Stenosis of an iliac branch occurred in one patient after 3 months and was successfully treated by angioplasty. Late endoleaks were detected by imaging follow-up in four cases, three at 1 year and one at 6 months, requiring deployment of distal extender cuffs (n = 2), a proximal cuff (n = 1), and lumbar embolization (n = 2). Conclusion: Our preliminary experience supports the efficacy of endovascular repair in selected patients, but strict and accurate follow-up is required.