Endovascular Repair of Abdominal Aortic Aneurysms Using 3 Commercially Available Devices:Midterm Results

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Abstract
To report the early and midterm results of 3 commercially available stent-grafts for abdominal aortic aneurysm (AAA) exclusion. Since fall 1999, 151 patients (137 men; mean age 74 years, range 54–88) have undergone AAA repair using 88 Ancure, 46 AneuRx, and 17 Excluder stent-grafts in elective procedures. All patients were followed clinically and underwent postoperative duplex ultrasound and/or computed tomographic angiography, which was repeated every 6 months. The mean overall follow-up was 17 months (range 1–46). Initial technical failure was 3% (3/88) for Ancure versus 0% for AneuRx and Excluder. Primary endoleak occurred in 8% (7/88) of the Ancure patients versus 22% (10/46) for AneuRx and 6% (1/17) for Excluder (p=NS). Early (30-day) graft thrombosis (2/151, 1%) was seen only in the Ancure group. The perioperative complication rates (excluding endoleak and fever) were 22% (19/88) for Ancure, 15% (7/46) for AneuRx, and 0% for Excluder (p=NS). There was only 1 (0.7%) perioperative death in the series (Ancure patient). More ancillary procedures were performed in the Ancure group (p<0.05). Postoperatively, the size of the AAA decreased or remained unchanged in 76% for Ancure patients versus 75% for AneuRx and 64% for Excluder (p=NS). The incidences of late endoleak were 6% for Ancure, 2% for AneuRx, and 0% for Excluder (p=NS). The freedom from late endoleak at 3 years was 88% for Ancure and 97% for AneuRx (100% at 1 year for Excluder). Survival rates were similar. No AAA rupture was recorded. The Ancure device has slightly higher overall perioperative complications and early technical failure than AneuRx or Excluder. All 3 devices are effective in preventing aneurysm rupture; the overall midterm survival rates, freedom of endoleak, and limb patency are somewhat similar. To report the early and midterm results of 3 commercially available stent-grafts for abdominal aortic aneurysm (AAA) exclusion. Since fall 1999, 151 patients (137 men; mean age 74 years, range 54–88) have undergone AAA repair using 88 Ancure, 46 AneuRx, and 17 Excluder stent-grafts in elective procedures. All patients were followed clinically and underwent postoperative duplex ultrasound and/or computed tomographic angiography, which was repeated every 6 months. The mean overall follow-up was 17 months (range 1–46). Initial technical failure was 3% (3/88) for Ancure versus 0% for AneuRx and Excluder. Primary endoleak occurred in 8% (7/88) of the Ancure patients versus 22% (10/46) for AneuRx and 6% (1/17) for Excluder (p=NS). Early (30-day) graft thrombosis (2/151, 1%) was seen only in the Ancure group. The perioperative complication rates (excluding endoleak and fever) were 22% (19/88) for Ancure, 15% (7/46) for AneuRx, and 0% for Excluder (p=NS). There was only 1 (0.7%) perioperative death in the series (Ancure patient). More ancillary procedures were performed in the Ancure group (p<0.05). Postoperatively, the size of the AAA decreased or remained unchanged in 76% for Ancure patients versus 75% for AneuRx and 64% for Excluder (p=NS). The incidences of late endoleak were 6% for Ancure, 2% for AneuRx, and 0% for Excluder (p=NS). The freedom from late endoleak at 3 years was 88% for Ancure and 97% for AneuRx (100% at 1 year for Excluder). Survival rates were similar. No AAA rupture was recorded. The Ancure device has slightly higher overall perioperative complications and early technical failure than AneuRx or Excluder. All 3 devices are effective in preventing aneurysm rupture; the overall midterm survival rates, freedom of endoleak, and limb patency are somewhat similar.