Bifurcated Endovascular Graft for Abdominal Aortic Aneurysm Repair: A Multi-Center Trial of the PowerWeb™ System

(Department of Surgery II, Tokyo Medical University, Tokyo, Japan, Department of Cardiovascular Surgery, Fukushima Dai-ichi Hospital*¹, Fukushima, Japan, Department of Cardiovascular Surgery, Tokai University School of Medicine*², Isehara, Japan, Department of Surgery, Yamaguchi Prefectural Central Hospital*³, Hofu,Japan and Department of Surgery, Kurume University School of Medicine*4, Kurume, Japan)

Shin Ishimaru Satoshi Kawaguchi Shunichi Hoshino*¹
Hirofumi Midorikawa*¹ Shirosaku Koide*² Shinichirou Shimura*²
Kensuke Esato*³ Nobuya Zenpo*³ Shigeaki Aoyagi*4
Hirotoshi Tanaka*4
Infra-renal abdominal aortic aneurysms were electively treated by bifurcated endovascular stent grafts (PowerWeb™ system, Endologix Co., USA) at 5 Japanese centers. The stent grafting (SG) was applied for candidates nominated by the selection committee after informed consent was obtained according to the IRB in each center. The delivery success rate of 60 patients (53 males) was 96.7%. There were 2 patients with type I endoleaks, resulting in a technical success rate of 93.3%. The operation time of 193}55 min and blood loss of 440}240 g were significantly shorter and less, respectively in the SG group when compared with 303}88 min and 1,496}2,025 g in 97 patients (83 males) treated by conventional open surgery. Endoleaks were detected in 4 patients (type I: 3, type II: 1) by CT scan taken at the time of discharge or 1 month after SG procedure. Type I endoleak was observed in patients with short and severely angulated SG landing zones. Renal artery obstruction, and temporary buttock pain caused by internal iliac artery occlusion occurred, but there was no hospital death. In 56 patients excluding an SG-unrelated death and a dropout from surveillance, there was no secondary endoleak or marked adverse events at all except 1SG limb occlusion during a 6-month follow up period. The aneurysm size shrank in 26 patients and remained unchanged in 30 patients. No aneurysm enlargement was observed. The PowerWeb™ system is appropriate for minimally invasive surgery for abdominal aortic aneurysms. Long-term follow-up studies will follow.
@Jpn. J. Cardiovasc. Surg. 33: 81-86 (2004)