The EVT Tube and Bifurcated Endograft Systems: Technical Considerations and Clinical Summary

Abstract

Endovascular exclusion of abdominal aortic aneurysms (AAAs) is an investigational technique under scrutiny around the world. The tube and bifurcated versions of the Endovascular Grafting System (EGS) developed by Endovascular Technologies are the subjects of FDA-approved multicenter trials in the United States (US). Similar studies are under way in Europe, Australia, and the United Kingdom. This review details the implantation techniques for the EGS device and summarizes the important clinical findings published through 1996.

Although the EGS was voluntarily removed from the US trial when fractures were discovered in the graft attachment system, subsequent experience with the re-engineered EGS has been positive. Successfully implanted EGS tube grafts have been associated with aneurysm shrinkage after 1 year in AAAs initially excluded or with sealed endoleaks. Aneurysm enlargement has been seen in EGS tube grafts with persistent endoleak.

Keywords

endovascular grafting endograft abdominal aortic aneurysm aneurysm exclusion endoleak

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References

Lazarus

. Intraluminal graft device, system and method. US Patent Number 4,787,899,1988.

Lazarus

. Endovascular grafting for the treatment of abdominal aortic aneurysms. Surg Clin North Am 1992;72:959–968.

Moore

. Endovascular grafting technique: A feasibility study. In: Yao

JST

Pearce

eds. Aneurysms: New Findings and Treatments. Norwalk, CT, Appleton and Lange, 1993:333–340.

Moore

Vescera

. Repair of abdominal aortic aneurysm by transfemoral endovascular graft placement. Ann Surg 1994;220:331–341.

Moore

. Transfemoral endovascular repair of abdominal aortic aneurysm using the endovascular graft system device. In: Greenhalgh

ed. Vascular and Endovascular Surgical Techniques: An Atlas, 3rd ed. Philadelphia, WB Saunders, 1994:78–91.

Moore

. The role of endovascular grafting technique in the treatment of infrarenal abdominal aortic aneurysm. Cardiovasc Surg 1995;3:109–114.

Colburn

Moore

. Endovascular repair of abdominal aortic aneurysms using the EGS tube and bifurcated graft systems. World J Surg 1996;20:664–672.

Moore

. Transfemoral endovascular repair of abdominal aortic aneurysm. J Irish Coll Phys Surg 1996;25:104–109.

Moore

Rutherford

for the EVT Investigators . Transfemoral endovascular repair of abdominal aortic aneurysm: Results of the North American EVT phase 1 trial. J Vasc Surg 1996;23:543–553.

10.

Balm

Eikelboom

May

. Early experience with transfemoral endovascular aneurysm management (TEAM) in the treatment of aortic aneurysms. Eur J Vasc Endovasc Surg 1996;11:214–220.

11.

May

White

. A prospective study of changes in morphology and dimensions of abdominal aortic aneurysms following endoluminal repair: A preliminary report. J Endovasc Surg 1995;2:343–347.

12.

Matsumura

Pearce

McCarthy

. Reduction in aortic aneurysm size: Early results after endovascular graft placement. J Vasc Surg 1997;25:113–123.