Aortic Neck Attachment Failure and the AneuRx Graft: Incidence, Treatment Options, and Early Results
Section snippets
INTRODUCTION
Endovascular abdominal aortic aneurysm (AAA) repair (EVAR) has become an increasingly accepted treatment alternative for selected patients with infrarenal AAAs since the 1999 approval of the AneuRx (Medtronic, Santa Rosa, CA) and Ancure (Guidant, Santa Clara, CA) devices. The AneuRx device is currently the most frequently used endovascular graft in the United States, with over 34,000 implants since approval and more than 38,000 patients worldwide. The 5-year mid-term follow-up data on the U.S.
Patient Selection
All patients undergoing endovascular aortoiliac aneurysm repair at our institution are prospectively entered in a database for long-term follow-up and comparison of their outcomes. Between October 1999 and October 2003, 620 patients underwent EVAR at our institution using a variety of approved and investigational devices. During that period, 365 patients underwent EVAR using the AneuRx device. These patients and their associated data were reviewed under a Health Insurance Portability and
RESULTS
Eighteen of the 20 patients who developed proximal attachment failure were successfully treated at a mean follow-up of 23.7 ± 14,8 months from the date of the original graft implantation. These patients were treated with AneuRx aortic cuff (n = 9), Talent aortic cuff (n = 6), Palmaz stent (n = 5), Excluder aortic cuff (n = 1), or surgical conversion (n = 2), Some patients required multiple procedures, or multiple modalities were used at the time of the intervention for endovascular graft
DISCUSSION
The reported 5-year clinical results for the U.S. AneuRx trial include 97.2% freedom from allcause rupture, 91.1% freedom from surgical conversion, and 96.8% freedom from aneurysm-related death.1 These outstanding results were obtained despite the limited experience of many physicians and the learning curve associated with using endovascular devices. Since the start of that trial in 1996, we have gained significant knowledge of the behavior of the device and endovascular techniques in general.
REFERENCES (8)
- et al.
Reporting standards for endovascular aortic aneurysm repair
J Vasc Surg
(2002) - et al.
Device migration after endoluminal abdominal aortic aneurysm repair analysis of 113 cases with a minimum follow-up period of 2 years
J Vasc Surg
(2002) - et al.
Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: a cautionary note
J Vasc Surg
(2002) - et al.
Nature, frequency, and predictors of secondary procedures after endovascular repair of abdominal aortic aneurysm
J Vasc Surg
(2003)
Cited by (0)
Presented at the Spring Meeting of the Peripheral Vascular Surgery Society, Anaheim, CA, June 5, 2004.