Endovascular repair of abdominal aortic aneurysms: Initial experience with 100 consecutive patients

Stephane Elkouri, Peter Gloviczki, Michael A. McKusick, Jean M. Panneton, James C. Andrews, Thomas C. Bower, Audra A. Noel, Timothy M. Sullivan, Linda G. Canton, William S. Harmsen, Tanya L. Hoskin, Kenneth J. Cherry

Research output: Contribution to journalReview article

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Abstract

Objective: To review early results of endovascular repair of abdominal aortic aneurysms (AAAs). Patients and Methods: The first 100 patients who underwent endovascular repair of AAA (EVAR) between June 26, 1996, and October 31, 2001, at the Mayo Clinic in Rochester, Minn, were studied retrospectively to evaluate technical success, freedom from reinterventions, and early clinical outcome. Results: A total of 89 men and 11 women (mean ± SD age, 76±7 years; range, 47-92 years) underwent EVAR. The procedure was successful in 97 patients. There was no early death. Major complications occurred in 25 patients. The 30-day technical success rate was 86% (95% confidence interval [CI], 77%-92%). The median intensive care unit stay was 1 day (range, 1-15 days), and the median hospital stay was 3 days (range, 1-35 days). Median follow-up was 7 months (range, 1-60 months). Endoleak (incomplete seal of the endovascular graft) at discharge was observed in 14 patients; 13 developed endoleak during follow-up. There were 23 reinterventions, 65% of which were percutaneous procedures. One aneurysm ruptured at 5 months, but the patient was successfully treated by open repair. Primary and secondary graft patency rates at 1 year were 83% (95% CI, 74%-93%) and 94% (95% CI, 87%-99%), respectively. The freedom from reintervention rate at 1 year was 71% (95% CI, 59%-84%), with an overall success rate from EVAR of 92% (95% CI, 84%-100%). There were no differences in early patency, reinterventions, and success rates between unibody and modular devices. Conclusion: EVAR can be performed with high technical success and low mortality rates; however, nonfatal complications and catheter-based reinterventions are frequent, and EVAR may not prevent aneurysm rupture. Although stent graft repair for high-risk patients is appealing, current data are insufficient to support EVAR as the preferred treatment of AAAs.

Original languageEnglish (US)
Pages (from-to)1234-1242
Number of pages9
JournalMayo Clinic Proceedings
Volume78
Issue number10
StatePublished - Oct 1 2003

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Abdominal Aortic Aneurysm
Confidence Intervals
Endoleak
Transplants
Ruptured Aneurysm
Stents
Aneurysm
Intensive Care Units
Rupture
Length of Stay
Catheters
Equipment and Supplies
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Elkouri, S., Gloviczki, P., McKusick, M. A., Panneton, J. M., Andrews, J. C., Bower, T. C., ... Cherry, K. J. (2003). Endovascular repair of abdominal aortic aneurysms: Initial experience with 100 consecutive patients. Mayo Clinic Proceedings, 78(10), 1234-1242.

Endovascular repair of abdominal aortic aneurysms : Initial experience with 100 consecutive patients. / Elkouri, Stephane; Gloviczki, Peter; McKusick, Michael A.; Panneton, Jean M.; Andrews, James C.; Bower, Thomas C.; Noel, Audra A.; Sullivan, Timothy M.; Canton, Linda G.; Harmsen, William S.; Hoskin, Tanya L.; Cherry, Kenneth J.

In: Mayo Clinic Proceedings, Vol. 78, No. 10, 01.10.2003, p. 1234-1242.

Research output: Contribution to journalReview article

Elkouri, S, Gloviczki, P, McKusick, MA, Panneton, JM, Andrews, JC, Bower, TC, Noel, AA, Sullivan, TM, Canton, LG, Harmsen, WS, Hoskin, TL & Cherry, KJ 2003, 'Endovascular repair of abdominal aortic aneurysms: Initial experience with 100 consecutive patients', Mayo Clinic Proceedings, vol. 78, no. 10, pp. 1234-1242.
Elkouri S, Gloviczki P, McKusick MA, Panneton JM, Andrews JC, Bower TC et al. Endovascular repair of abdominal aortic aneurysms: Initial experience with 100 consecutive patients. Mayo Clinic Proceedings. 2003 Oct 1;78(10):1234-1242.
Elkouri, Stephane ; Gloviczki, Peter ; McKusick, Michael A. ; Panneton, Jean M. ; Andrews, James C. ; Bower, Thomas C. ; Noel, Audra A. ; Sullivan, Timothy M. ; Canton, Linda G. ; Harmsen, William S. ; Hoskin, Tanya L. ; Cherry, Kenneth J. / Endovascular repair of abdominal aortic aneurysms : Initial experience with 100 consecutive patients. In: Mayo Clinic Proceedings. 2003 ; Vol. 78, No. 10. pp. 1234-1242.
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abstract = "Objective: To review early results of endovascular repair of abdominal aortic aneurysms (AAAs). Patients and Methods: The first 100 patients who underwent endovascular repair of AAA (EVAR) between June 26, 1996, and October 31, 2001, at the Mayo Clinic in Rochester, Minn, were studied retrospectively to evaluate technical success, freedom from reinterventions, and early clinical outcome. Results: A total of 89 men and 11 women (mean ± SD age, 76±7 years; range, 47-92 years) underwent EVAR. The procedure was successful in 97 patients. There was no early death. Major complications occurred in 25 patients. The 30-day technical success rate was 86{\%} (95{\%} confidence interval [CI], 77{\%}-92{\%}). The median intensive care unit stay was 1 day (range, 1-15 days), and the median hospital stay was 3 days (range, 1-35 days). Median follow-up was 7 months (range, 1-60 months). Endoleak (incomplete seal of the endovascular graft) at discharge was observed in 14 patients; 13 developed endoleak during follow-up. There were 23 reinterventions, 65{\%} of which were percutaneous procedures. One aneurysm ruptured at 5 months, but the patient was successfully treated by open repair. Primary and secondary graft patency rates at 1 year were 83{\%} (95{\%} CI, 74{\%}-93{\%}) and 94{\%} (95{\%} CI, 87{\%}-99{\%}), respectively. The freedom from reintervention rate at 1 year was 71{\%} (95{\%} CI, 59{\%}-84{\%}), with an overall success rate from EVAR of 92{\%} (95{\%} CI, 84{\%}-100{\%}). There were no differences in early patency, reinterventions, and success rates between unibody and modular devices. Conclusion: EVAR can be performed with high technical success and low mortality rates; however, nonfatal complications and catheter-based reinterventions are frequent, and EVAR may not prevent aneurysm rupture. Although stent graft repair for high-risk patients is appealing, current data are insufficient to support EVAR as the preferred treatment of AAAs.",
author = "Stephane Elkouri and Peter Gloviczki and McKusick, {Michael A.} and Panneton, {Jean M.} and Andrews, {James C.} and Bower, {Thomas C.} and Noel, {Audra A.} and Sullivan, {Timothy M.} and Canton, {Linda G.} and Harmsen, {William S.} and Hoskin, {Tanya L.} and Cherry, {Kenneth J.}",
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AU - Elkouri, Stephane

AU - Gloviczki, Peter

AU - McKusick, Michael A.

AU - Panneton, Jean M.

AU - Andrews, James C.

AU - Bower, Thomas C.

AU - Noel, Audra A.

AU - Sullivan, Timothy M.

AU - Canton, Linda G.

AU - Harmsen, William S.

AU - Hoskin, Tanya L.

AU - Cherry, Kenneth J.

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N2 - Objective: To review early results of endovascular repair of abdominal aortic aneurysms (AAAs). Patients and Methods: The first 100 patients who underwent endovascular repair of AAA (EVAR) between June 26, 1996, and October 31, 2001, at the Mayo Clinic in Rochester, Minn, were studied retrospectively to evaluate technical success, freedom from reinterventions, and early clinical outcome. Results: A total of 89 men and 11 women (mean ± SD age, 76±7 years; range, 47-92 years) underwent EVAR. The procedure was successful in 97 patients. There was no early death. Major complications occurred in 25 patients. The 30-day technical success rate was 86% (95% confidence interval [CI], 77%-92%). The median intensive care unit stay was 1 day (range, 1-15 days), and the median hospital stay was 3 days (range, 1-35 days). Median follow-up was 7 months (range, 1-60 months). Endoleak (incomplete seal of the endovascular graft) at discharge was observed in 14 patients; 13 developed endoleak during follow-up. There were 23 reinterventions, 65% of which were percutaneous procedures. One aneurysm ruptured at 5 months, but the patient was successfully treated by open repair. Primary and secondary graft patency rates at 1 year were 83% (95% CI, 74%-93%) and 94% (95% CI, 87%-99%), respectively. The freedom from reintervention rate at 1 year was 71% (95% CI, 59%-84%), with an overall success rate from EVAR of 92% (95% CI, 84%-100%). There were no differences in early patency, reinterventions, and success rates between unibody and modular devices. Conclusion: EVAR can be performed with high technical success and low mortality rates; however, nonfatal complications and catheter-based reinterventions are frequent, and EVAR may not prevent aneurysm rupture. Although stent graft repair for high-risk patients is appealing, current data are insufficient to support EVAR as the preferred treatment of AAAs.

AB - Objective: To review early results of endovascular repair of abdominal aortic aneurysms (AAAs). Patients and Methods: The first 100 patients who underwent endovascular repair of AAA (EVAR) between June 26, 1996, and October 31, 2001, at the Mayo Clinic in Rochester, Minn, were studied retrospectively to evaluate technical success, freedom from reinterventions, and early clinical outcome. Results: A total of 89 men and 11 women (mean ± SD age, 76±7 years; range, 47-92 years) underwent EVAR. The procedure was successful in 97 patients. There was no early death. Major complications occurred in 25 patients. The 30-day technical success rate was 86% (95% confidence interval [CI], 77%-92%). The median intensive care unit stay was 1 day (range, 1-15 days), and the median hospital stay was 3 days (range, 1-35 days). Median follow-up was 7 months (range, 1-60 months). Endoleak (incomplete seal of the endovascular graft) at discharge was observed in 14 patients; 13 developed endoleak during follow-up. There were 23 reinterventions, 65% of which were percutaneous procedures. One aneurysm ruptured at 5 months, but the patient was successfully treated by open repair. Primary and secondary graft patency rates at 1 year were 83% (95% CI, 74%-93%) and 94% (95% CI, 87%-99%), respectively. The freedom from reintervention rate at 1 year was 71% (95% CI, 59%-84%), with an overall success rate from EVAR of 92% (95% CI, 84%-100%). There were no differences in early patency, reinterventions, and success rates between unibody and modular devices. Conclusion: EVAR can be performed with high technical success and low mortality rates; however, nonfatal complications and catheter-based reinterventions are frequent, and EVAR may not prevent aneurysm rupture. Although stent graft repair for high-risk patients is appealing, current data are insufficient to support EVAR as the preferred treatment of AAAs.

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