Turhan YAVUZ, Mustafa ETLİ, Mert KÖROĞLU, Ulaş SAĞLAM, Mustafa KAYAN, Ergün CEYLAN, Şeyma BENZİN, Seda İBİŞOĞLU, Esma Dilek ÜSTÜN

Endovascular treatment of abdominal aortic aneurysms with Endologix® stent graft : Single-site experiences and short-term follow-up outcomes

Aim: The aim of this study was to investigate the short-term results of endovascular repair of abdominal aortic aneurysms with the Endologix IntuiTrak Powerlink XL® (Endologix) stent graft and to share our clinical experiences in our center. Materials and methods: Endovascular stent graft treatment was applied in 16 cases with infrarenal abdominal aortic aneurysm (13 men and 3 women; mean age: 70.2 years) in 2009 and 2010. Before treatment, all of the patients were examined with 128-slice computed tomography (CT) angiography for the assessment of abdominal aortic aneurysms. The Endologix stent graft (bifurcated system) was used for all of the patients. Results: The aneurysms of the 16 patients were located at the infrarenal level. They were treated with aortobiiliac stent graft s. The technical success rate was 100%. No mortality, major complications, or need of urgent conversion to open surgery occurred in any of the patients. Only 1 patient died due to acute coronary syndrome in the early follow-up period and 1 patient was lost in the follow-up period. There were no aneurysm ruptures, graft migrations, or graft fractures in any of the patients. Conclusion: Endovascular treatment of infrarenal aortic aneurysms with the Endologix stent graft has a high degree of technical success and is a useful alternative to surgery.

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1. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991; 5: 491-9.
2. Samy AK, Whyte B, MacBain G. Abdominal aortic aneurysm in Scotland. Br J Surg 1994; 81: 1104-6.
3. Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG, EVAR trial participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 2004; 364: 843-8.
4. Prinssen M, Verhoeven ELG, Buth J, Cuypers PWM, van Sambeek MRHM, Balm R et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 2004; 351: 1607- 18.
5. Mehta M, Taggert J, Darling RC 3rd, Chang BB, Kreienberg PB, Paty PSK et al. Establishing a protocol for endovascular treatment of ruptured abdominal aortic aneurysms: outcomes of a prospective analysis. J Vasc Surg 2006; 44: 1-8.
6. Sadat U, Boyle JR, Walsh SR, Tang T, Varty K, Hayes PD. Endovascular vs open repair of acute abdominal aortic aneurysms - a systematic review and meta-analysis. J Vasc Surg 2008; 48: 227-36.
7. Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW et al. Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 2002; 346: 1437-44.
8. Jordan WD, Alcocer F, Wirthlin DJ, Westfall AO, Whitley D. Abdominal aortic aneurysms in high-risk surgical patients. Comparison of open and endovascular repair. Ann Surg 2003; 237: 629-30.
9. Bley TA, Chase PJ, Reeder SB, François CJ, Shinki K, Tefera G et al. Endovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up. Radiology 2009; 253: 253-62.
10. Zarins CK, AneuRx Clinical Investigators. The US AneuRx Clinical Trial: 6-year clinical update 2002. J Vasc Surg 2003; 37: 904-8.
11. Du Toit DF, Saaiman JA, Carpenter JP, Geldenhuys KM. Endovascular aortic aneurysm repair by a multidisciplinary team: lessons learned and six-year clinical update. Cardiovasc J S Afr 2005; 16: 36-47.
12. Dereume JPE, Fereira J. The Corvita system. In: Hopkins B, Yusuf W, Whitaker S, Veith F, editors. Endovascular surgery for aortic aneurysms. London: WB Saunders; 1997. p.122-39.
13. Sanfelippo PM. Abdominal aortic aneurysm2003: what we know, what we dont knowa review. Int J Angiol 2003; 12: 145-52.
14. Halloran BG, Davis VA, McManus BM, Lynch TG, Baxter BT. Localization of aortic disease is associated with intrinsic differences in aortic structure. J Surg Res 1995; 59: 17-22.
15. Stone DH, Brewster DC, Kwolek CJ, Lamuraglia GM, Conrad MF, Chung TK et al. Stent-graft versus open-surgical repair of the thoracic aorta: mid-term results. J Vasc Surg 2006; 44: 1188-97.
16. Rahman A, Çolak MC, Özdemir H, Özgüler M, Çil BE. Aortic aneurysms treatment with endovascular stent-graft . Türk Göğüs Kalp Damar Cer Derg 2009; 17: 167-72 (in Turkish with English abstract).
17. Tom CW, Krajcer Z. Use of the IntuiTrak stent-graft delivery system for percutaneous abdominal aortic aneurysm exclusion: initial single-center experience. Tex Heart Inst J 2010; 37: 331-3.
18. Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK, Bernhard VM et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg 2002; 35: 1048-60.
19. Golzarian J, Maes EB, Sun S. Endoleak: treatment options. Tech Vasc Interv Radiol 2005; 8: 41-9.