Transluminal Endovascular Stent-Graft for the Treatment of Aortic Aneuryms

ABSTRACT

PURPOSE: The standard treatment for aortic aneurysms is surgical replacement with a prosthetic graft. Currently there is great interest in endoluminal intervention for treatment of aortic aneurysm. The purpose of this study was to evaluate the safety and effectiveness of endoluminally placed Stent-graft for the treatment of aortic aneurysms. MATERIALS AND METHODS: Transluminal endovascular Stent-graft placements were attempted in 9 patients with infra-renal aortic aneurysms(n=6), thoracic aortic aneurysm(n=l), and aortic dissection(n=2). The endovascular Stent-grafts were custom-designed for each patient and were constructed of self-expandable modified Gianturco Stents covered with polytetrafluroethylene. The Stent-grafts were introduced through a 16-18 french sheath and expanded to 17-30mm in diameter. The endovascular therapy was performed using a common femoral artery cutdown with local anesthesia. RESULTS: The endovascular Stent-graft deployment was achieved in 7 of 9 patients. Two cases failed deployment of the Stent-graft due to lilac artery stenosis and tortousity. There were complete thrombosis of the thoracic and infra-renal aortic aneurysm surround the Stent-graft in 3 patients, and persistent leak with partial thrombosis in 2. Two patients with aortic dissection were successfully treated by obliteration of entry tears. There were no major complication associated with Stent-graft placement. CONCLUSION: These preliminary results show that transluminal endovascular Stent-grafts offer great promise and good results. Further investigation is needed to establish its long-term safety and efficacy.