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[Endovascular treatment for abdominal aortic aneurysm, a primary study].

OBJECTIVE
To summarize the initial experience of endoluminal stent-grafting in the treatment of abdominal aortic aneurysm (AAA).


METHODS
Stent-graft of proper shape and size was selected according to the morphology of AAA and was inserted into the lumen of abdominal aortic aneurysm through femoral artery to reconstruct the blood flow under X-ray flouroscopy among 34 cases. Data on complications and morphological changes were obtained according to a strict follow-up plan.


RESULTS
The stent-grafting procedure was technically successful in all 34 patients. None of them required open repair. Five patients (14.7%) suffered from primary endoleaks after stent-graft deployment and 1 patient suffered from paraplegia and acute graft thrombosis. No other complications (kidney infarction, limbs and colon ischemia, etc) were found. The average follow-up time was 21 +/- 4.7 months. Perioperative death rate was 0% and total death rate was 3%. Two cases with primary endoleak developed into lasting endoleak during the follow-up period with a rate of late endoleak (> 30 days) of 11.7%. Secondary endoleak was found in 2 cases. One case with limb stent disconnection accepted secondary intervention. The mean max aneurysm diameter in cases without endoleak decreased significantly 6 months to 2 years after operation (P < 0.01). The aneurysm in two cases with secondary type I endoleak increased and one of them underwent secondary intraluminal treatment.


CONCLUSION
Endovascular technique is a reliable method of treating AAA with micro-trauma. Endoleak is the main complication of this technique. Follow-up is an important component of the treatment plan. The aim of endoluminal repair is to completely neglect the aneurysmal lumen and prevent the aneurysm from increasing during follow-up.