Early and Mid-Term Results of Endovascular Stent-Graft Placement for the Treatment of Abdominal Aortic Aneurysms

(Department of Surgery 1,Hirosaki University School of Medicine, Hirosaki, Japan and Division of Cardiac Surgery, Southern Tohoku General Hospital*, Koriyama, Japan)

Shoichi Takahashi* Shunichi Takaya Ikko Ichinoseki
Masaharu Hatakeyama Kazuyuki Daitoku Toshihiko Kuga
Mamoru Munakata Kozo Fukui Ikuo Fukuda
We performed endovascular stent-graft placement on 39 patients with abdominal aortic aneurysms between 1996 and March 2002―a period of approximately 5 years (first half: until the end of June 1998,second half: July 1998 onward). Three patients in the first half of the period and 8 patients in the second half were 80 years or older. Two cases of mycotic aneurysm were observed. During the second half, we encountered high-risk cases in which the patients had complications such as coronary artery disease (5 patients), COPD (1 patient) and thoracic aortic aneurysm (4 patients). Although we had to switch to surgery in 3 patients during the first half of the period, we successfully placed stent-grafts in the other 36 cases (92%). Endoleaks were observed in 6 patients, and dissection of the iliac artery was observed in 5 patients (stents had been placed in all patients). In 50% of all cases in the first half of the period and 89% of all cases in the second half, stent-graft placement was successful and no endoleak was observed. During the follow-up period,3 cases required additional treatment, and another 4 cases required surgery. Four patients died in hospital during the first half of the period, and 3 patients died during the following 3 years. The 3-year survival rate was 82%. It was considered that stent-graft placement for abdominal aortic aneurysms is particularly effective for high-risk patients, and that the results of this type of therapy will improve in the future.
 Jpn. J. Cardiovasc. Surg. 32: 224 -229 (2003)