A Retrospective Review of Endovascular Aneurysm Repair (EVAR) for Abdominal Aortic Aneurysm (AAA) with Home-made Devices

ABSTRACT

PURPOSE: This study was performed to assess the safety and efficacy of Endovascular Aneurysm Repair (EVAR) with a home-made stent graft. METHOD: The medical records of 17 patients who underwent EVAR at Seoul National University Hospital between January 1995 and December 2003 were analyzed retrospectively. The outcomes were measured with respect to efficacy (deployment success rate, technical success rate, conversion rate, and reintervention rates) and safety (30-day mortality rate, complication rate, endoleaks, graft thrombosis, stenosis, and migration). RESULT: The median follow-up of the patients was 42.8 months (range, 2.7~72.67 months). The male to female ratio was 7.5 (15:2). The deployment success rate was 100% and the technical success rate was 70.6% at discharge. Early complications were present in five patients (29%). Late complications occurred in 47% of the cases. Secondary intervention to treat complications was required in 29% of patients. Open repairs were performed in two patients (12%), one with an immediate type Ia endoleak and the other for migrations. The cumulative patient survival rate was 94.1%, 76.0% and 57.0% at 1, 3 and 5 years follow up. The overall clinical success rate during follow-up was 38.5%. CONCLUSION: Although EVAR with a home-made device in high-risk patients showed good early technical outcomes, there were complications. Continued device innovation, good compliance and close surveillance are required for these patients.