Midterm results of a modified technique for implanting tube grafts during endovascular abdominal aortic aneurysm repair.

Purpose: To retrospectively analyze the efficacy and midterm results of endovascular aneurysm repair (EVAR) with a tubular stent-graft using 2 different implantation techniques.

Methods: Between November 2004 and September 2007, 53 patients (49 men; mean age 68.5+/-8.6 years, range 40-80) were treated with the EndoFit tube stent-graft. The majority (45, 85%) were treated using the trombone technique, in which 2 tubular aortoaortic endografts were deployed with 4 to 8 cm of overlap. This subgroup was compared to the 8 patients who received single tube grafts.

Results: Technical and procedural success were 100%; perioperative mortality was 0%. Operative results were similar for patients treated with 1 graft versus those treated with the overlapping trombone technique. The overall device-related complication rate was significantly lower for patients treated with the trombone technique (11% versus 75%, p<0.001). Mean follow-up was 24 months (range 6-36). Endoleak type II occurred in 3 (5.7%) cases. Three (5.7%) patients died, 1 from an aortoduodenal fistula secondary to a proximal type I endoleak and 2 from acute myocardial infarction.

Conclusion: The tubular EndoFit device appears both safe and effective in terms of midterm clinical outcome, especially when the trombone technique is utilized. It compares favorably with previously reported EVAR results.