Midterm clinical success and behavior of the aneurysm sac after endovascular AAA repair with the Excluder graft

Germano Melissano, Luca Bertoglio, Gloria Esposito, Efrem Civilini, Francesco Setacci, Roberto Chiesa

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: Recent studies have reported different sac behavior after endovascular repair of abdominal aortic aneurysms, depending on the endografts. This study was designed to evaluate mid-term outcome and sac behavior after treatment with the Gore Excluder stent-graft. Methods: Between June 1999 and January 2005, 109 selected patients with suitable anatomy were treated electively for abdominal aortic aneurysm with the Excluder stent graft. Data were prospectively collected in a computerised database and included demographics, details of the aortoiliac anatomy, procedural and clinical success, and postoperative complications. Postoperative sac size and the presence of endoleaks were assessed with computed tomography scans obtained at 1, 6, and 12 months, and yearly thereafter. All diameter measures in patients followed for >1 year (84.4%) were analyzed. Results: Assisted primary technical success was achieved in 108 cases (99.1%). No type I endoleaks and 12 (11.1%) type II endoleaks were recorded ≤1 month from the procedure. Mean follow-up was 29.6 ± 16.1 months. We recorded one new-onset type IA endoleak, complete resolution of five type II endoleaks, and eight new-onset type II endoleaks. The overall prevalence of type II endoleaks was 14%. Shrinkage at 1, 2, 3, and 4 years was observed in 20.7%, 30.5%, 38.9%, and 36.8% of cases. The presence of type II endoleak influenced the trend of aneurysm size throughout the 4 years. Aneurysms without endoleak shrank more than aneurysms with type II endoleak (P<.0001). We observed two cases of sac enlargement due to the presence of endoleaks. No cases of endotension with sac enlargement, late open conversion, or aneurysm-related deaths were observed. Unchanged aneurysmal sacs remained stable during follow-up, with no adverse events. Conclusions: Endovascular treatment with the Excluder device in selected patients produces low rates of shrinkage, but this peculiar sac behavior does not affect mid-term clinical success.

Original languageEnglish
Pages (from-to)1052-1057
Number of pages6
JournalJournal of Vascular Surgery
Volume42
Issue number6
DOIs
Publication statusPublished - Dec 2005

Fingerprint

Endoleak
Aneurysm
Transplants
Abdominal Aortic Aneurysm
Stents
Anatomy
Tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Midterm clinical success and behavior of the aneurysm sac after endovascular AAA repair with the Excluder graft. / Melissano, Germano; Bertoglio, Luca; Esposito, Gloria; Civilini, Efrem; Setacci, Francesco; Chiesa, Roberto.

In: Journal of Vascular Surgery, Vol. 42, No. 6, 12.2005, p. 1052-1057.

Research output: Contribution to journalArticle

@article{32a5de0ed45a47859a88c425ea0a972a,
title = "Midterm clinical success and behavior of the aneurysm sac after endovascular AAA repair with the Excluder graft",
abstract = "Objective: Recent studies have reported different sac behavior after endovascular repair of abdominal aortic aneurysms, depending on the endografts. This study was designed to evaluate mid-term outcome and sac behavior after treatment with the Gore Excluder stent-graft. Methods: Between June 1999 and January 2005, 109 selected patients with suitable anatomy were treated electively for abdominal aortic aneurysm with the Excluder stent graft. Data were prospectively collected in a computerised database and included demographics, details of the aortoiliac anatomy, procedural and clinical success, and postoperative complications. Postoperative sac size and the presence of endoleaks were assessed with computed tomography scans obtained at 1, 6, and 12 months, and yearly thereafter. All diameter measures in patients followed for >1 year (84.4{\%}) were analyzed. Results: Assisted primary technical success was achieved in 108 cases (99.1{\%}). No type I endoleaks and 12 (11.1{\%}) type II endoleaks were recorded ≤1 month from the procedure. Mean follow-up was 29.6 ± 16.1 months. We recorded one new-onset type IA endoleak, complete resolution of five type II endoleaks, and eight new-onset type II endoleaks. The overall prevalence of type II endoleaks was 14{\%}. Shrinkage at 1, 2, 3, and 4 years was observed in 20.7{\%}, 30.5{\%}, 38.9{\%}, and 36.8{\%} of cases. The presence of type II endoleak influenced the trend of aneurysm size throughout the 4 years. Aneurysms without endoleak shrank more than aneurysms with type II endoleak (P<.0001). We observed two cases of sac enlargement due to the presence of endoleaks. No cases of endotension with sac enlargement, late open conversion, or aneurysm-related deaths were observed. Unchanged aneurysmal sacs remained stable during follow-up, with no adverse events. Conclusions: Endovascular treatment with the Excluder device in selected patients produces low rates of shrinkage, but this peculiar sac behavior does not affect mid-term clinical success.",
author = "Germano Melissano and Luca Bertoglio and Gloria Esposito and Efrem Civilini and Francesco Setacci and Roberto Chiesa",
year = "2005",
month = "12",
doi = "10.1016/j.jvs.2005.05.009",
language = "English",
volume = "42",
pages = "1052--1057",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Midterm clinical success and behavior of the aneurysm sac after endovascular AAA repair with the Excluder graft

AU - Melissano, Germano

AU - Bertoglio, Luca

AU - Esposito, Gloria

AU - Civilini, Efrem

AU - Setacci, Francesco

AU - Chiesa, Roberto

PY - 2005/12

Y1 - 2005/12

N2 - Objective: Recent studies have reported different sac behavior after endovascular repair of abdominal aortic aneurysms, depending on the endografts. This study was designed to evaluate mid-term outcome and sac behavior after treatment with the Gore Excluder stent-graft. Methods: Between June 1999 and January 2005, 109 selected patients with suitable anatomy were treated electively for abdominal aortic aneurysm with the Excluder stent graft. Data were prospectively collected in a computerised database and included demographics, details of the aortoiliac anatomy, procedural and clinical success, and postoperative complications. Postoperative sac size and the presence of endoleaks were assessed with computed tomography scans obtained at 1, 6, and 12 months, and yearly thereafter. All diameter measures in patients followed for >1 year (84.4%) were analyzed. Results: Assisted primary technical success was achieved in 108 cases (99.1%). No type I endoleaks and 12 (11.1%) type II endoleaks were recorded ≤1 month from the procedure. Mean follow-up was 29.6 ± 16.1 months. We recorded one new-onset type IA endoleak, complete resolution of five type II endoleaks, and eight new-onset type II endoleaks. The overall prevalence of type II endoleaks was 14%. Shrinkage at 1, 2, 3, and 4 years was observed in 20.7%, 30.5%, 38.9%, and 36.8% of cases. The presence of type II endoleak influenced the trend of aneurysm size throughout the 4 years. Aneurysms without endoleak shrank more than aneurysms with type II endoleak (P<.0001). We observed two cases of sac enlargement due to the presence of endoleaks. No cases of endotension with sac enlargement, late open conversion, or aneurysm-related deaths were observed. Unchanged aneurysmal sacs remained stable during follow-up, with no adverse events. Conclusions: Endovascular treatment with the Excluder device in selected patients produces low rates of shrinkage, but this peculiar sac behavior does not affect mid-term clinical success.

AB - Objective: Recent studies have reported different sac behavior after endovascular repair of abdominal aortic aneurysms, depending on the endografts. This study was designed to evaluate mid-term outcome and sac behavior after treatment with the Gore Excluder stent-graft. Methods: Between June 1999 and January 2005, 109 selected patients with suitable anatomy were treated electively for abdominal aortic aneurysm with the Excluder stent graft. Data were prospectively collected in a computerised database and included demographics, details of the aortoiliac anatomy, procedural and clinical success, and postoperative complications. Postoperative sac size and the presence of endoleaks were assessed with computed tomography scans obtained at 1, 6, and 12 months, and yearly thereafter. All diameter measures in patients followed for >1 year (84.4%) were analyzed. Results: Assisted primary technical success was achieved in 108 cases (99.1%). No type I endoleaks and 12 (11.1%) type II endoleaks were recorded ≤1 month from the procedure. Mean follow-up was 29.6 ± 16.1 months. We recorded one new-onset type IA endoleak, complete resolution of five type II endoleaks, and eight new-onset type II endoleaks. The overall prevalence of type II endoleaks was 14%. Shrinkage at 1, 2, 3, and 4 years was observed in 20.7%, 30.5%, 38.9%, and 36.8% of cases. The presence of type II endoleak influenced the trend of aneurysm size throughout the 4 years. Aneurysms without endoleak shrank more than aneurysms with type II endoleak (P<.0001). We observed two cases of sac enlargement due to the presence of endoleaks. No cases of endotension with sac enlargement, late open conversion, or aneurysm-related deaths were observed. Unchanged aneurysmal sacs remained stable during follow-up, with no adverse events. Conclusions: Endovascular treatment with the Excluder device in selected patients produces low rates of shrinkage, but this peculiar sac behavior does not affect mid-term clinical success.

UR - http://www.scopus.com/inward/record.url?scp=29144452479&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=29144452479&partnerID=8YFLogxK

U2 - 10.1016/j.jvs.2005.05.009

DO - 10.1016/j.jvs.2005.05.009

M3 - Article

VL - 42

SP - 1052

EP - 1057

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 6

ER -