Purpose: To evaluate feasibility, safety, and effectiveness of endovascular abdominal aortic aneurysm (AAA) repair in patients whose fitness for surgery is questionable.
Methods: Between April 1997 and December 2001, 389 consecutive patients underwent endovascular AAA repair. Of these, 51 (13.1%) were ASA grade IV. The perioperative and late outcomes of this group were compared to the remaining 338 patients with ASA grades
Results: Four (7.8%) perioperative deaths occurred in the ASA IV group compared to 1 (0.3%) in the ASA
Conclusions: Endovascular AAA repair in ASA IV patients is feasible and effective in preventing AAA rupture in the mid term. High-risk patients experience a worse prognosis than their good-risk counterparts. An individualized approach in selecting high-risk patients for endoluminal repair is mandatory.
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