Midterm Results of a Modified Technique for Implanting Tube Grafts During Endovascular Abdominal Aortic Aneurysm Repair

1st Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
Journal of Endovascular Therapy (Impact Factor: 3.35). 08/2008; 15(4):433-40. DOI: 10.1583/08-2411.1
Source: PubMed


To retrospectively analyze the efficacy and midterm results of endovascular aneurysm repair (EVAR) with a tubular stent-graft using 2 different implantation techniques.
Between November 2004 and September 2007, 53 patients (49 men; mean age 68.5+/-8.6 years, range 40-80) were treated with the EndoFit tube stent-graft. The majority (45, 85%) were treated using the trombone technique, in which 2 tubular aortoaortic endografts were deployed with 4 to 8 cm of overlap. This subgroup was compared to the 8 patients who received single tube grafts.
Technical and procedural success were 100%; perioperative mortality was 0%. Operative results were similar for patients treated with 1 graft versus those treated with the overlapping trombone technique. The overall device-related complication rate was significantly lower for patients treated with the trombone technique (11% versus 75%, p<0.001). Mean follow-up was 24 months (range 6-36). Endoleak type II occurred in 3 (5.7%) cases. Three (5.7%) patients died, 1 from an aortoduodenal fistula secondary to a proximal type I endoleak and 2 from acute myocardial infarction.
The tubular EndoFit device appears both safe and effective in terms of midterm clinical outcome, especially when the trombone technique is utilized. It compares favorably with previously reported EVAR results.

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    • "Aorto-aortic tubes have a series of advantages over bifurcated and conical grafts. The implantation procedure usually takes less time and radiations and the overall cost is substantially reduced [9]. Tubular endografts are also less likely to occlude as they have no kinking or twisting, if compared to bifurcated and aorto-monoiliac devices [10]. "
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    ABSTRACT: Background: We describe our 8-year experience with the use of endovascular techniques (ET) for the treatment of abdominal aortic aneurysms (AAA) through a straight endograft. Methods: We retrospectively reviewed data of all patients who were treated for AAA using ET in two centres from 1998 to 2012 and who received a single straight endograft (group A) or a double straight tube (group B). Outcomes were analyzed to assess survival, absence of endoleak and absence of reintervention for both groups. Log-rank and Chi-Square were used as appropriate to make comparison between the two groups. P values < .05 were considered statistically significant. Results: Fifty-three patients from 1998 to May 2012 were treated for AAA using a straight endograft. In 28 cases (52.8%) a single aortic straight tube was used (Group A), while in the remaining cases a "double trombone technique" was used (Group B). Conclusions: In our experience the endovascular repair of AAA using straight aortic endografts was a safe and effective technique. Reintervention and endoleaks were slightly more frequent in patients who had received a single endograft compared to patients who were treated using the "trombone technique".
    Full-text · Article · Apr 2013 · Journal of Cardiothoracic Surgery
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