Long-Term Single-Center Results with AneuRx Endografts for Endovascular Abdominal Aortic Aneurysm Repair

Purpose: To evaluate the longterm single-center results with the AneuRx stent-graft in endovascular abdominal aortic aneurysm (AAA) repair (EVAR). Methods: Between December 1996 and August 2003, 212 patients (197 men; mean age 71.3±7.0 years) were treated with the AneuRx stent-graft for an infrarena...

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Bibliographic Details
Published in:Journal of endovascular therapy 2007-06, Vol.14 (3), p.307-317
Main Authors: van Herwaarden, Joost A., van de Pavoordt, Eric D.W.M., Waasdorp, Evert J., Vos, Jan Albert, Overtoom, Tim ThC, Kelder, Johannes C., Moll, Frans L., de Vries, Jean-Paul P.M.
Format: Article
Language:English
Subjects:
Aged
Aneurysms
Aortic Aneurysm, Abdominal - mortality
Aortic Aneurysm, Abdominal - surgery
Aortic Rupture - etiology
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Female
Follow-Up Studies
Foreign-Body Migration - etiology
Hospitals
Humans
Kaplan-Meier Estimate
Length of Stay
Male
Mortality
Proportional Hazards Models
Prospective Studies
Prosthesis Design
Reoperation
Risk Assessment
Severity of Illness Index
Stents
Surgery
Time Factors
Treatment Outcome
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Summary:Purpose: To evaluate the longterm single-center results with the AneuRx stent-graft in endovascular abdominal aortic aneurysm (AAA) repair (EVAR). Methods: Between December 1996 and August 2003, 212 patients (197 men; mean age 71.3±7.0 years) were treated with the AneuRx stent-graft for an infrarenal AAA. Post-operatively, patients were enrolled in a fixed surveillance protocol, and data were prospectively captured into a database. Results: Graft deployment was successful in 98.6% (209/212). Thirty-day mortality was 2.4%. Median hospital stay was 4.3±5.5 days. Median followup was 52.0 months (range 1–109); only 1 patient was lost to followup. At 9 years, patient survival was 56% and freedom from secondary interventions was 48%. In 68% of cases, these reinterventions were needed for a fixation-related complication, and most of these complications (75%) encompassed the area of the proximal aneurysm neck. Primary clinical success was 37% at 9 years. After secondary interventions, the assisted primary clinical success improved to 73% at 9 years. Freedom from aneurysm-related death was 97% at 1 year and 90% at 9 years. Conclusion: As an alternative to open repair, EVAR with the AneuRx device has low perioperative mortality. Reinterventions are mostly due to fixation-related complications. While the overall mortality risk in this population was 5% per year, annual aneurysm-related death was only 1%. The focus should be on surveillance and reducing the rate of longterm complications, which might be possible with improved proximal stent-graft fixation.
ISSN:1526-6028
1545-1550
DOI:10.1583/06-1993.1