The Australian and New Zealand journal of surgery · 1996
A self-expanding endoluminal graft for treatment of aneurysms: results through the development phase.
СтатьяНазвание и аннотация: Перевод в очереди
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Gordon M K, Lawrence-Brown M M, Hartley D, Sieunarine K, Holden A, MacSweeney S T, Hellings M J
Аннотация
BACKGROUND: The results of two and a half years' experience of endoluminal treatment of aneurysmal disease (from March 1993 to December 1995) are reported.
METHODS: The endoluminal grafts were individually made at Royal Perth Hospital. They are based on Dacron-covered stainless steel self-expanding 'Z' stents with Gianturco barbed stents (Cook Pty, Australia) for proximal anchorage for grafts within the aorta.
RESULTS: Fourteen straight tube grafts (nine for aortic aneurysm, four for iliac aneurysm and one for subclavian aneurysm) and 24 bifurcate grafts were deployed; all were in patients considered high-risk for conventional repair. Seventy-two per cent of the straight tube grafts successfully excluded the aneurysm. The bifurcate grafts, in use since July 1994, successfully excluded the aneurysm in 88%. There were two delayed deaths from rupture after the grafts failed to exclude the aneurysms; two patients required conversion to open repair and survived; three patients have persistent endoleaks; and three of the bifurcate grafts subsequently occluded a graft limb but did not require further intervention. Ninety per cent of these complications occurred in the first half of the series (prior to January 1995).
CONCLUSIONS: A learning and development curve was clearly apparent. The results thereafter compare favourably to those for open repair in similar high-risk groups, suggesting that these techniques hold promise for all patients with aneurysms.
METHODS: The endoluminal grafts were individually made at Royal Perth Hospital. They are based on Dacron-covered stainless steel self-expanding 'Z' stents with Gianturco barbed stents (Cook Pty, Australia) for proximal anchorage for grafts within the aorta.
RESULTS: Fourteen straight tube grafts (nine for aortic aneurysm, four for iliac aneurysm and one for subclavian aneurysm) and 24 bifurcate grafts were deployed; all were in patients considered high-risk for conventional repair. Seventy-two per cent of the straight tube grafts successfully excluded the aneurysm. The bifurcate grafts, in use since July 1994, successfully excluded the aneurysm in 88%. There were two delayed deaths from rupture after the grafts failed to exclude the aneurysms; two patients required conversion to open repair and survived; three patients have persistent endoleaks; and three of the bifurcate grafts subsequently occluded a graft limb but did not require further intervention. Ninety per cent of these complications occurred in the first half of the series (prior to January 1995).
CONCLUSIONS: A learning and development curve was clearly apparent. The results thereafter compare favourably to those for open repair in similar high-risk groups, suggesting that these techniques hold promise for all patients with aneurysms.
Предметные рубрики MeSH
AgedAged, 80 and overAneurysmAortic Aneurysm, AbdominalAortic RuptureBlood Vessel ProsthesisCause of DeathEquipment DesignFemoral ArteryFollow-Up StudiesGraft Occlusion, VascularHumansIliac AneurysmMiddle AgedPolyethylene TerephthalatesPostoperative ComplicationsRisk FactorsStainless SteelStentsSubclavian ArterySurvival RateTomography, X-Ray Computed