Endovascular treatment of abdominal aorta aneurysms using bifurcated endoprosthesis

Abstract

Objective. To obtain an initial assessment of the implantation technique of bifurcated vascular endoprothesis in the treatment of abdominal aorta aneurysms (AAA). Methods. Eleven Vanguard type endoprostheses were implanted in eleven patients with infra-renal aortic aneurysm. The technique was performed with surgical approach in one femoral artery, and percutaneously in the other. The procedure was performed with epidural anesthesia. Results. A technical success - i.e., the exclusion of the aneurysm - was obtained in all cases. No technical complications occurred during the procedure. Three patients had low degree contrast leak in the angiographic control immediately after the procedure. Eight patients had low grade fever in the immediate follow-up which resolved with medical therapy, two patients had hematomas in the approach sites, one renal infarction, one ileus for two days, another one for five days, and three patients had lymphatic effusion. During follow-up the patients with leak had to undergo co-axial endoprosthesis implantation. Conclusions. It is our view that bifurcated vascular endoprostheses offer a valid alternative in the treatment of AAA. The procedure can be performed with epidural anesthesia and sedation, with a low rate of complications. The long term follow-up and the perfectioning of the approach and resection systems will ultimately dictate their usefulness in this and other vascular conditions.