Initial experience with abdominal aneurysm repair using the E-vita abdominal stent-graft: a single-center study.

摘要

PURPOSE: To evaluate the feasibility and midterm results of a new stent-graft for infrarenal endovascular aneurysm repair (EVAR) in a non-selected population. METHODS: Nineteen consecutive patients (19 men; mean age 70 years, range 58-87) who presented within an 8-month period with abdominal aortic aneurysms (AAA) suitable for EVAR were treated with the new E-vita abdominal stent-graft. Most of the patients (13, 68%) were ASA grade 3 or higher; the maximum AAA diameter was 57 mm (40-75), and hostile necks were present in a third and tortuous iliac arteries in half. Most of the cases (18, 95%) were elective; 1 was performed for a contained rupture. Seventeen procedures were primary implantations and 2 were secondary repairs of failing endografts. RESULTS: All stent-grafts were implanted at the intended position; no conversions to open surgery were necessary and no type I endoleak was noted. Fifteen bifurcated and 4 straight stent-grafts were implanted; the majority of the vascular accesses (29/35, 83%) were percutaneous. There was no 30-day mortality. In the mean 10-month follow-up (range 4-17), no stent fractures, migrations, or secondary endoleaks were noted. Aneurysm diameter was reduced in 8 (42%) and remained unchanged in 11 (58%) patients. One patient required open surgery at 1 year for thrombotic occlusion of the stent-graft. Two octogenarian patients died during follow-up. CONCLUSION: The E-vita abdominal stent-graft appears safe and effective in this initial midterm clinical experience. This device appears especially suitable to challenging aneurysm anatomy, such as severely angulated necks or tortuous and dilated iliac arteries.