[Nine years' experience with endovascular treatment of abdominal aortic aneurysms].

BACKGROUND

Endovascular repair of abdominal aortic aneurysm was started nine years ago at our institution. Our purpose was to evaluate the results over this period.

MATERIAL AND METHODS

From 1995 to 2003, a total of 148 patients were treated for infrarenal abdominal aortic aneurysms by endovascular repair. The material includes 31 patients (21%) who were unfit for open surgery because of comorbidity or poor general condition. The patients have been followed up at regular intervals with clinical investigation, plain abdominal X-ray, and CT scans. Regional anaesthesia was used for 143 procedures; 5 were carried out under general anaesthesia.

RESULTS

30-day mortality following elective procedures was 2.3%. 31 endo-leaks were observed, 16 early and 15 late. Furthermore, 22 graft limb occlusions were diagnosed and thirteen of them repaired with femoro-femoral bypass. Secondary procedures were necessary in 42 (28.4%) of the patients, including 7 late conversions to open surgery. Some patients had more than one secondary procedure. With better stent grafts, the incidence of complications and secondary procedures has decreased significantly. During the last 4.5 years, only 4 secondary procedures (5.8%) have been necessary in 69 patients. In the total material the accumulated five-year survival rate was about 60%.

INTERPRETATION

Results from endovascular repair of abdominal aortic aneurysm have improved in recent years. Ongoing prospective randomised studies could give us the information we need in order to establish what role this treatment should have.