Stent Graft Repair of Abdominal Aortic Aneurysm

Abstract

The aortic stent graft currently represents a pinnacle in the evolution of endovascular technology - beginning with the DeBakey Dacron, vascular graft (which remains a gold standard), through catheter-based approaches to vascular disease. culminating in the introduction of the endovascular stent by Palmaz in 1985.1 Subsequently, while searching for a minimally invasive treatment for patients with abdominal aortic aneurysm (AAA) that are too sick for open surgery, Juan Parodi (1991) was the first to combine the Dacron graft with a Palmaz stent.2 Parodi sewed Pafmaz stents onto the graft, crimped the entire device onto an angioplasty balloon, and became the first to deliver an endoluminaf graft into the aorta. By excluding the aneurysm internally, reducing pressure on the aortic wall, and preventing rupture, the repair of aortic aneurysms was changed forever. Since it is unusual for aneurysms to be confined to the aorta alone, bifurcated grafts, which extend into the common iliac arteries, were a natural extension of this technology.3 Parodi’s pioneering work led to the development of the first commercially available stent grafts in 1997, the Medtronic Aneuryx gratt4 and the Guidant Ancure graft.5,6 Today there are three commercially available grafts in the United States, with another five in development.?