Endovascular treatment of abdominal aortic aneurysms in Norway: the first 100 patients.

Objectives: to present the first 100 consecutive endograft implantations for abdominal aortic aneurysms (AAAs) in Norway.

Design: retrospective study of 100 consecutive graft implantations, performed at five University Hospitals during 1995 to 1997.

Material: one hundred patients with a median age of 70 years were included. In all patients the Vanguard modular system (Boston Scientific Corp.) was used. Ninety-four of the 100 patients were treated under regional anaesthesia. A completion angiography was done to evaluate the position of the graft and whether endoleaks were present.

Results: two patients died within 30 days, one due to cardiac insufficiency and another due to haemorrhage during the procedure. There were four early conversions to open repair. At discharge eight patients had an endoleak, while retrograde flow into the aneurysmal sac was observed in four patients. During the follow-up period one conversion to open repair became necessary due to graft migration. Four late leaks were all repaired successfully using endovascular techniques. Five cases of retrograde filling were detected and embolisation with coils was performed in two cases, while three were observed. Seven graft-limb occlusions occurred during the follow-up period and four of these required treatment.

Conclusions: endovascular AAA repair should be regarded as an experimental treatment, although the short term results are promising. Close follow-up of patients with CT scans or arteriography is necessary.