A Modular Aortouniiliac Endovascular Stent-graft is a Useful Device for the Treatment of Symptomatic and Ruptured Infrarenal Abdominal Aortic Aneurysms: One-year Results from a Multicentre Study

IntroductionEndovascular repair (EVAR) of acute symptomatic and ruptured abdominal aortic aneurysm (rAAA) can be difficult without a large stock of suitable graft sizes. We report a prospective European multicentre study of a modular aortouniiliac stent-graft.Patients and methodsSeven centres, with elective EVAR experience, participated in the study. Sixty-five patients were enrolled from September 2002 – April 2005. Some 45 patients had rAAA and 20 were acutely symptomatic. Their median age was 74 (69–80.3) years, 49 (75%) were men. From a choice of 4 body and 4 limb sizes, stent-grafts were deployed under local or general anaesthesia.ResultsThe endovascular delivery system was introduced and the aneurysm excluded from the circulation in a median of 40 (30–60) minutes from the first incision.The median operative duration was 150 (120–190) mins, blood loss 300 ml (200–800). 33 (51%) operations were performed by a vascular surgeon alone.There were a total of 4 (6%) peri-operative re-interventions, endovascular (n = 1), open (n = 2) and thrombectomy (n = 1). The peri-operative mortality in the rupture group was 40% and 10% in the symptomatic group.ConclusionsAortouniiliac stent-grafts provide rapid exclusion of rAAA. Suitably trained surgeons can do the operation without a radiologist's support. The mortality rate from rAAA treated with EVAR remains high.