Endovascular stent-graft applications in abdominal aortic aneurysms: mid- and long-term results

Abstract

Background: This study aims to discuss the mid- and long-term results of our endovascular interventions for the management of abdominal aortic pathologies for six years. Methods: Seventy-two patients (51 males, 21 females; mean age 69.6 years; range 49 to 83 years) with endovascular stentgraft implantations performed in our clinic between April 2006 and June 2012 were retrospectively analyzed. The mean diameter was 66.2 mm in infrarenal abdominal aortic aneurysms and 63.9 mm in iliac artery aneurysms. Fifty-six patients underwent elective surgery, while 16 patients were emergency. The quantity of the aneurysms by their anatomic localizations were reported as 61 in infrarenal aorta and aortoiliac level, 11 isolated in iliac artery. The mean hospitalization time was 5.2 days (range, 1-32 days). The mean follow-up time was 33.3 months (range, 4-64 months). Results: An emergency intervention was performed for 10 abdominal aorta and six iliac artery aneurysms. Three patients underwent cross femoral bypass due to an occluded leg of the graft, a complication seen during surgery. Two patients underwent embolectomy intraoperatively; while one underwent embolectomy postoperatively. Endoleak developed in 16 patients intraoperatively and in nine patients postoperatively. Postoperative complications included graft migration in two patients, increased aneurysm diameter in four patients, and relapsed aneurysm distal to the graft following endovascular intervention in two patients. In-hospital mortality occurred in nine patients (12.5%), while 30-day mortality was seen in three patients (4.1%). Conclusion: We conclude that it is early for endovascular aortic repair to take the place of traditional surgical treatment based on the mid- and long-term results.