Peripheral Vascular Surgery Society

Andy M. Lee, MD, Caron B. Rockman, MD, Patrick J. Lamparello, MD,

Gary G. Giangola, MD, Robert J. Rosen, MD, Thomas S. Riles, MD,

and Ronnie Landis, BSN.

New York University Medical Center

New York, NY

Patients/Methods: This study was performed as a participating medical center in the Phase 1 and Phase 2 evaluations of the EVT device. We reviewed the 25 cases performed at our institution.

Results: The patient population consisted of 21 males (84%) and 4 females (16%), with a mean age of 73.4 years. A total of nine tube grafts (36%) and 16 bifurcated grafts (64%) were attempted. Twenty-two of the twenty-five procedures were successfully completed endovascularly (88%). Implantation failures were most often due to tortuousity or inadequate caliber of the iliac arteries, or incorrect positioning of the graft. Mean operative time was 203 minutes; mean hospital stay was 12 days. There was no perioperative mortality. Major complications included two unilateral graft limb thromboses. The mean length of follow-up was 13 months (range 1-36 months). Complications in follow-up included three cases of residual aneurysm flow (12%). Only one of these was persistent (4%); this particular leak, in combination with a proximal hook fracture, led to a pseudoaneurysm and eventual explantation at 26 months. The other two cases had residual aneurysm flow noted on ultrasound examination at three months; both have since completely resolved. Our total "endoleak" rate of 12%, and persistent leak rate of 4% is considerably lower than the typical rates reported in the literature.

Conclusion: Endovascular repair of abdominal aortic aneurysms is an appropriate treatment for selected patients. Conversions to open repair have decreased as experience has grown; careful patient selection can minimize the number of unsuccessful implantations. Patient selection and accurate technique can also minimize the number of "endoleaks".