Endovasculaire behandeling van een aneurysma aortae abdominalis. Eerste ervaringen met 20 patiënten in Eindhoven

Evaluation of the early results of endovascular abdominal aortic aneurysm (AAA) repair.

Design

Prospective cohort study.

Setting

Catharina Hospital, Eindhoven, the Netherlands.

Methods

Operative results and complications following endovascular AAA repair in 20 consecutive patients were surveyed. The early results consisted of the procedural outcome and the events during a mean follow-up of 6.6 months (range: 1-12 months). Nine patients had a considerably increased operation risk (American Society of Anesthesiology (ASA) class III of IV). Criteria for success were absence of endoleak and of further expansion of the aneurysm.

Resullts

Three of the nine patients in bad general shape suffered an episode of cardiac failure after the operation. In the other patients there were no serious systemic complications. No patient died. Sixteen patients (80) had a successful immediate AAA exclusion. In two patients a second endovascular procedure was required to seal an endoleak. In one patient the procedure was converted to an open reconstruction because of a persistent endoleak, while in another patient a small midgraft endoleak was treated conservatively. Ultimately 18 patients (90) had a successful endovascular AAA repair.

Conclusion

Endovascular AAA repair is feasible with a high success rate and a low complication rate. This method is expected to gain an important place in future AAA repair. Longer follow-up is needed to study late complications, among which occurrence of early and late endoleaks is the most important.