Endovascular Treatment of Abdominal Aortic Aneurysm by Bifurcated Stent Graft

Purpose: To evaluate the effectiveness and safety of endoluminal bifurcated stent graft for the treatment of AAA .Materials and Methods: Between August 1997 and August 1998, 20 patients with AAA underwent treatment involving the use of a bifurcated stent graft. Fourteen in whom the aneurysm involved only bifurcation and six patients n whom the common iliac arteries were involved. For one patient, a stent with a short proximal neckmeasuring 12 mm was used. The stent graft was inserted by means of a unilateral surgical femoral arteriotomy. After the procedure, follow up involving CT and aortography was performed between month 3 and month 12.Results: The primary success rate with the first trial was 79 percent (15 of 19 patients), and the overall success rate was 84 percent; one perigraft leak was successfully corrected. In one case, technical failure occurred dueto a tortuous iliac vessel and spasm. Procedure-related complications occurred in 16% of patients (3 of 19), one of whom died due to acute renal failure following a contrast overdose.Conclusion: Endovascular treatment of infrarenal AAA by means of a bifurcated stent graft was effective and safe. In particular, if the proximal neck measured more than 1cm, any AAA could be treated using a bifurcated stent graft. Further investigation of the outcome and complications arising during long-term follow-up are needed, however.