Long-term single-center results with AneuRx endografts for endovascular abdominal aortic aneurysm repair

J Endovasc Ther. 2007 Jun;14(3):307-17. doi: 10.1583/06-1993.1.

Abstract

Purpose: To evaluate the long-term single-center results with the AneuRx stent-graft in endovascular abdominal aortic aneurysm (AAA) repair (EVAR).

Methods: Between December 1996 and August 2003, 212 patients (197 men; mean age 71.3+/-7.0 years) were treated with the AneuRx stent-graft for an infrarenal AAA. Postoperatively, patients were enrolled in a fixed surveillance protocol, and data were prospectively captured into a database.

Results: Graft deployment was successful in 98.6% (209/212). Thirty-day mortality was 2.4%. Median hospital stay was 4.3+/-5.5 days. Median follow-up was 52.0 months (range 1-109); only 1 patient was lost to follow-up. At 9 years, patient survival was 56% and freedom from secondary interventions was 48%. In 68% of cases, these reinterventions were needed for a fixation-related complication, and most of these complications (75%) encompassed the area of the proximal aneurysm neck. Primary clinical success was 37% at 9 years. After secondary interventions, the assisted primary clinical success improved to 73% at 9 years. Freedom from aneurysm-related death was 97% at 1 year and 90% at 9 years.

Conclusion: As an alternative to open repair, EVAR with the AneuRx device has low perioperative mortality. Reinterventions are mostly due to fixation-related complications. While the overall mortality risk in this population was 5% per year, annual aneurysm-related death was only 1%. The focus should be on surveillance and reducing the rate of long-term complications, which might be possible with improved proximal stent-graft fixation.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Rupture / etiology
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Female
  • Follow-Up Studies
  • Foreign-Body Migration / etiology
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Proportional Hazards Models
  • Prospective Studies
  • Prosthesis Design
  • Reoperation
  • Risk Assessment
  • Severity of Illness Index
  • Stents*
  • Time Factors
  • Treatment Outcome