Endoluminal Graft Repair of Abdominal Aortic Aneurysms by Vascular Surgeons at a Nonclinical Trial Center

Abstract

The purpose of this study was to compare the early results and complication rates of commercially available endoluminal grafts (ELG) for abdominal aortic aneurysm (AAA) by a team of vascular surgeons at a nontrial center with those of published results from trial centers. A retrospective chart review of all patients undergoing endoluminal graft repair of AAA was made at the medical center. From October 1, 1999, to December 31, 2000, a team of vascular surgeons electively repaired AAAs in 100 patients at a regional referral center. Of these patients, 49 underwent repair with a commercially available ELG (35 AneuRx, 14 Ancure) whereas the remaining were repaired with an open operation. In the ELG group, the primary technical success rate was 100% with a 30-day mortality rate of 2.0%. The average hospital length of stay was 3.28 days with ICU stay of 1.20 days. The average operative estimated blood loss was 501 mL (100-2,500) with average transfusions of 0.49 unit packed red blood cells (prbc) (0-6). Eighty-eight percent of ELG patients left the hospital without complication.Seven patients (14%) required 1 1 follow-up procedures for complications including endoleak, limb or graft thrombosis, graft stenosis, distal embolization, or wound complications. Three of 26 patients (1 1%) with 6-month computed tomography follow-up had evidence of endoleak (2 have subsequently undergone lumbar embolization). Only 1 6-month follow-up patient had shown increased aneurysm size before endoleak treatment. A team of board-certified vascular surgeons at a nonclinical trial center can safely perform ELG for AAA with results similar to those of published series from trial centers.