Clinical Experiences of Stented Graft

ABSTRACT

PURPOSE: Endovascular repair is a alternative treatment with favorable short-term result, but long term results are not available compared to standard operation. The authors have reviewed experiences of Asan Medical Center on stented graft, performed from Aug. 1998 to Feb. 2000, and the results as to age, operative indication, clinical condition, anatomic location, complication, follow-up are reported. METHOD: Seven patients who has received stented graft between Aug. 1998 and Feb. 2000 are reviewed retrospectively. RESULT: Of the seven patients, 6 were male and 1 was female. The mean age was 46.4 years (17~71). Indication for stented graft were two pseudoaneurysms, two iatrogenic arterio-venous fistulas, one thoracic aorta aneurysm, one abdominal aortic aneurysm, and one iliac artery occlusion with blue toe syndrome. Three different types of stented graft devices were utilized: Dacron-covered nitinol stented graft (made by the Asan Medical Center medical device team), Vanguard II (by Boston Scientific Corp.), and PTFE with nitinol stented graft (by Tae-woong). There was no perioperative mortality, and the technical success was achieved in five cases (71%). The patency at 14-month were 100% (5/5). Two immediate complications are hemorrhage due to iliac & femoral artery avulsion requiring emergency bypass grafting, and deployment failure of stented graft requiring removal of retained graft device. CONCLLUSION: Stented graft may be utilized even in complicated vascular situation but will need further development of device and more experience to prevent possible catastrophic complication. Indication should be decided by team approach and vascular surgeon should be prevent or participate during the procedure.