Lessons learned from the endovascular treatment of abdominal aortic aneurysm and a preliminary experience of our center

Background. The development of technical approaches for endovascular abdominal aortic aneurysm (AAA) repair during the last decade was briefly reviewed. The role of endovascular AAA repair as a new reliable method of treatment in high-risk patients was evaluated in both the major studies reported and a preliminary result of our center. Methods. General criteria for the selection and exclusion of high-risk patients were summarized. Six patients (mean age: 72 years) with complex infrarenal AAA underwent endovascular aneurysm repair using the bifurcated stent graft system. Routine follow-up examination included computed tomography performed periodically from the post-operative month up to one year. Patients suspected of endoleak underwent angiography and further endovascular treatment. Results. Successful deployment of the endograft and exclusion of the aneurysm was achieved in all six patients (100%) in our preliminary series. None of our patients required conversion to open aneurysmal repair. Comorbidity was an important factor in the outcome of aneurysm repair in high-risk patients, with cardiovascular disease and chronic obstructive pulmonary disease being the major comorbid conditions. Cardiac events were the most common complications, followed by transient renal failure, wound infection and endoleaks, which were corrected with endovascular treatment. Conclusions. The long-term results and efficacy of endovascular repair of infrarenal AAA remain to be demonstrated, but the procedure is believed to provide a safe and effective alternative treatment for high-risk patients suffering from AAA.