Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery最新文献

{"title":"Quality control during endovascular aneurysm repair: monitoring aneurysmal sac pressure and superficial femoral artery flow velocity.","authors":"G D Treharne,&nbsp;I M Loftus,&nbsp;M M Thompson,&nbsp;N Lennard,&nbsp;J Smith,&nbsp;G Fishwick,&nbsp;P R Bell","doi":"10.1583/1074-6218(1999)006<0239:QCDEAR>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0239:QCDEAR>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To use intraoperative aneurysmal sac pressure measurement and flow monitoring of the superficial femoral artery (SFA) to ensure complete exclusion of the aneurysm from the circulation.</p><p><strong>Methods: </strong>A 5F catheter was positioned in the aneurysmal sac of 15 consecutive patients undergoing endovascular aortomonoiliac aneurysm repair between February and September 1997. The catheter was connected to an external pressure transducer allowing pressure monitoring throughout the operation and for 24 hours postprocedurally. Flow velocity was monitored in the contralateral SFA by insonation with a 2-MHz Doppler ultrasound probe.</p><p><strong>Results: </strong>No technical defect was observed in the deployment of 10 endografts, which demonstrated marked reduction in sac pressure and good flow in the lower limb. The mean aneurysm pressure dropped from 123 to 57 mmHg after graft insertion. In 5 cases, monitoring detected problems during the endograft procedure. In 3, incomplete stent deployment was detected by a failure of sac pressure to fall following stent inflation and by the presence of flow in the contralateral femoral artery. In the other 2 cases, a distal endoleak was detected by direct injection of contrast into the sac.</p><p><strong>Conclusions: </strong>Measuring aneurysm pressure in combination with SFA Doppler flow monitoring can detect complications of endovascular aneurysm repair.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 3","pages":"239-45"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21357933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deformation of self-expanding stent-grafts complicating endovascular peripheral aneurysm repair.","authors":"M E Sitsen,&nbsp;G H Ho,&nbsp;J D Blankensteijn","doi":"10.1583/1074-6218(1999)006<0288:DOSSCE>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0288:DOSSCE>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate the deformation of self-expandable stents after endovascular repair of peripheral aneurysms.</p><p><strong>Methods and results: </strong>The Corvita Endoluminal Graft was used to treat a traumatic false aneurysm of the right subclavian artery and a common iliac artery aneurysm in 2 patients. In the subclavian case, the stent-graft showed a \"cigar-shaped\" deformation with hemodynamically significant stenoses at the proximal and distal ends at 3 months. In the second case, the same type of deformity was noted only 1 day after implantation. Two months later, the stent-graft occluded, necessitating surgical repair.</p><p><strong>Conclusions: </strong>Both cases demonstrate the possibility of stent deformation of self-expanding stent-grafts implanted at arterial sites not subject to external compression.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 3","pages":"288-92"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21358420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histology and electron microscopy of explanted bifurcated endovascular aortic grafts: evidence of early incorporation and healing.","authors":"Chung K. Shin, W. Rodino, J. Kirwin, J. Ramírez, W. Wisselink, G. Papierman, T. Panetta","doi":"10.1583/1074-6218(1999)006<0246:HAEMOE>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0246:HAEMOE>2.0.CO;2","url":null,"abstract":"PURPOSE To report an examination of explanted bifurcated endovascular aortic grafts for histologic evidence of early healing and incorporation. METHOD Two bifurcated endovascular aortic grafts composed of polycarbonate urethane and Elgiloy wire were explanted 42 and 21 days after successful endovascular exclusion of abdominal aortic aneurysms. Both patients expired from causes unrelated to endograft deployment. The explanted devices were examined using immunohistochemical analysis and electron microscopy. RESULTS On explantation, both grafts appeared to have excluded the aneurysm with no evidence of endoleak, graft migration, or thrombosis. Histological examination showed numerous inflammatory cells and good ingrowth of tissue into the proximal 2 cm of the graft. Collagen and smooth muscle cells were evident in the proximal portion of the graft with only collagen in the distal segments. Neointimal formation was seen within the proximal 2 cm also, but not at the distal segments. Macrophages were present in the graft. Scanning electron microscopy showed an extensive matrix of fibers that most likely represented collagen. CONCLUSIONS Bifurcated endovascular aortic grafts show inflammatory and mild foreign body reactions, collagen formation, and intimal ingrowth during healing. These findings are similar to some of the healing properties reported for sutured grafts, as well as other endovascular grafts.","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 1","pages":"246-250"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67344036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closure of large percutaneous access sites using the Prostar XL Percutaneous Vascular Surgery device.","authors":"P C Haas,&nbsp;Z Krajcer,&nbsp;E B Diethrich","doi":"10.1177/152660289900600209","DOIUrl":"https://doi.org/10.1177/152660289900600209","url":null,"abstract":"<p><strong>Purpose: </strong>To report early experience using a vascular closure device following endovascular aortic aneurysmal repair in which large-bore sheaths are used.</p><p><strong>Technique: </strong>A 10F Prostar XL Percutaneous Vascular Surgery device is used to deploy sutures around sheath entry sites up to 16F. At the completion of the procedure, the sutures are tied with a sliding knot to ensure adequate hemostasis.</p><p><strong>Conclusions: </strong>Maintaining the minimal invasiveness of the percutaneous approach to aortic endografting reduces patient discomfort and permits earlier ambulation and hospital discharge. Initial success seems to be maintained at 1 month, however, longer follow-up will be required.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"168-70"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/152660289900600209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoluminal repair of aneurysms containing ostia of essential branch arteries: an experimental model.","authors":"W Wisselink,&nbsp;F M Abruzzo,&nbsp;C K Shin,&nbsp;J R Ramirez,&nbsp;W Rodino,&nbsp;J D Kirwin,&nbsp;T F Panetta","doi":"10.1583/1074-6218(1999)006<0171:EROACO>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0171:EROACO>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To examine experimentally the feasibility of transfemoral endoluminal repair of aneurysms containing the ostia of essential branch arteries.</p><p><strong>Methods: </strong>In a canine model (n = 4), suprarenal aortic aneurysms were created by suturing an artificial patch onto an anterior arteriotomy. Following a 2-week recovery period, the dogs underwent endovascular exclusion of their aneurysms using an aortic stent-graft with separate renal artery branch grafts. Outcome was evaluated using angiography, intravascular ultrasound (IVUS), Doppler flow, invasive pressure monitoring, and autopsy, respectively.</p><p><strong>Results: </strong>Successful creation and subsequent endovascular exclusion of the aneurysm using aortic stent-grafts and separate bilateral renal artery stent-grafts was achieved in all trials. Angiographically, all aneurysms were excluded from aortic flow and all renal arteries were patent at completion of the procedure. With IVUS, good graft apposition and absence of perigraft flow were demonstrated in all animals. Mean pressure in the aneurysmal sac at completion of the procedure was 40 +/- 7 mmHg, compared to a mean systemic blood pressure of 105 +/- 8 mmHg (p < 0.05). At autopsy, no gross intimal damage was seen in the aorta or the renal arteries, and intact aortic grafts and branch grafts without twisting, coiling, or kinking were found in all trials.</p><p><strong>Conclusions: </strong>In an acute animal model, suprarenal aortic aneurysms can be excluded from the circulation with preservation of renal flow using an endoluminally placed aortic stent-graft with separate branch grafts.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"171-9"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subfascial perforator vein ablation: comparison of open versus endoscopic techniques.","authors":"D T Sato,&nbsp;C D Goff,&nbsp;R T Gregory,&nbsp;B F Walter,&nbsp;R G Gayle,&nbsp;F N Parent,&nbsp;R J DeMasi,&nbsp;G H Meier,&nbsp;J R Wheeler","doi":"10.1583/1074-6218(1999)006<0147:SPVACO>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0147:SPVACO>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes and complications of open (OSPS) versus endoscopic subfascial perforator surgery (SEPS) for treatment of chronic venous insufficiency.</p><p><strong>Methods: </strong>Data were retrospectively collected on 25 patients who underwent 27 SEPSs from February 1996 to August 1997 and from 22 patients who underwent 29 OSPSs between March 1978 and May 1993. Outcomes were evaluated for postoperative complications, ulcer healing, recurrence, and venous dysfunction scores on the last follow-up for the SEPS group and at 1-year follow-up for the OSPS group.</p><p><strong>Results: </strong>The 2 groups were similar in age, sex, history of previous venous surgery, healed or active ulcers, etiology, deep venous incompetency, pathophysiology, and venous refill times. Eighteen (90%) of 20 active ulcers in the SEPS group healed with recurrences in 5 (28%) limbs at 7.5 +/- 5.4-month follow-up. All 19 ulcers in the OSPS group healed, with recurrences in 13 (68%) limbs at 35 +/- 35-month follow-up. Clinical venous dysfunction scores showed significant improvement following SEPS (10.0 +/- 3.6 to 5.4 +/- 4.1, p < 0.001) and OSPS (10.0 +/- 3.2 to 6.7 +/- 3.6, p < 0.001) with no significant difference between groups. Both groups also had significant improvement in anatomical and disability scores. There was no postoperative mortality in either group. The OSPS group had significantly more wound complications (45%) than the SEPS group (7%) (p < 0.005). The hospital stay and readmission rate for wound problems were also higher in the OSPS group.</p><p><strong>Conclusions: </strong>The early outcome showed equal improvement in clinical venous dysfunction scores in the 2 groups, but with significantly fewer complications in the SEPS group. Although the long-term durability of the endoscopic approach has not been determined, the short-term results would favor SEPS for treatment of severe venous insufficiency when perforator incompetence is a significant component.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"147-54"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous stenting of the internal carotid artery: the European CAST I Study. Carotid Artery Stent Trial.","authors":"P Bergeron,&nbsp;J P Becquemin,&nbsp;J M Jausseran,&nbsp;G Biasi,&nbsp;J M Cardon,&nbsp;L Castellani,&nbsp;R Martinez,&nbsp;P Fiorani,&nbsp;P Kniemeyer","doi":"10.1583/1074-6218(1999)006<0155:PSOTIC>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0155:PSOTIC>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To report the results of a multicenter safety trial of percutaneous carotid stenting performed by vascular surgeons.</p><p><strong>Methods: </strong>Symptomatic or asymptomatic patients > or = 65 years of age with internal carotid artery (ICA) stenoses > or = 70% and < or = 2-cm long were eligible for enrollment. The procedures were performed in an operating room with the choice of anesthesia and the percutaneous access site at the discretion of the surgeon. Only Palmaz stents were used.</p><p><strong>Results: </strong>From January 1, 1996 to December 31, 1997, 99 patients (74 men, mean age 70 years, range 51 to 94) were enrolled in the study. More than half (57 of 99 patients) were asymptomatic. The direct cervical approach was used predominantly (97%). Three (3%) cases were converted to surgery for inability to access the artery or deploy the stent (technical success 97%). No perioperative death or myocardial infarction was reported. Six (6%) procedural complications included 1 reversible arterial spasm, 2 dissections, 1 cervical hematoma, and 2 residual stenoses. One neurological event reversed within 7 days (1% minor stroke rate) and 4 (4%) transient ischemic attacks resolved within 24 hours. One (1%) asymptomatic early occlusion occurred 2 days postoperatively. No neurological event was observed in the 1- to 24-month follow-up (mean 13 months). Two (2%) patients died of nonprocedurally related causes. No stent compression was seen, but 1 asymptomatic occlusion and 3 asymptomatic, non-flow-limiting restenoses (2 < 40%, 1 at 60%) were found within 1 year (3% restenosis rate on an intention-to-treat basis). Patency was 98% at 1 year.</p><p><strong>Conclusions: </strong>The results of this trial support the contention that carotid stenting of short ICA lesions can be performed with a low neurological complication rate.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"155-9"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular repair of aortic aneurysms: treatment of complications.","authors":"J Görich,&nbsp;N Rilinger,&nbsp;J Söldner,&nbsp;S Krämer,&nbsp;K H Orend,&nbsp;A Schütz,&nbsp;R Sokiranski,&nbsp;M Bartel,&nbsp;L Sunder-Plassmann,&nbsp;R Scharrer-Pamler","doi":"10.1583/1074-6218(1999)006<0136:EROAAT>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0136:EROAAT>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the use of interventional procedures for treating complications following endovascular repair of aortic aneurysms.</p><p><strong>Methods: </strong>Fifty-five patients (49 men; mean age 67.5 years) underwent endoluminal stent-graft repair of traumatic (n = 4) or arteriosclerotic (n = 51) aortic aneurysms in the thoracic (n = 3) or infrarenal (n = 52) aorta. Follow-up of therapeutic success included periodic clinical examination, angiography, and spiral computed tomography.</p><p><strong>Results: </strong>Discounting the 25 (45%) cases of postimplantation syndrome that did not require treatment, there were 22 complications observed in 20 (36%) patients over a mean 10-month follow-up (range 1 to 27). There were 2 transrenal endograft maldeployments, 1 case of twisted graft limbs, 2 access site problems (1 patient), 12 endoleaks (11 patients), 1 late graft limb thrombosis, 1 symptomatic internal iliac artery occlusion, 2 myocardial infarctions, and 1 transient psychosis. Seven (13%) patients did not undergo specific therapy, while 4 (7%) required operation (2 crossover bypass grafts, 1 suture revision, and 1 graft replacement). Among 9 (16%) patients treated with interventional techniques, 7 underwent percutaneous coil embolization for 8 endoleaks (7 successfully resolved). One late stent-graft disconnection required an additional stent-graft, and 1 of the 2 malpositioned endografts was repositioned. All patients remain alive with no increase in the diameter of the aneurysm in any patient.</p><p><strong>Conclusions: </strong>Technical problems resulting from the endovascular repair of aortic aneurysms often respond to interventional treatment.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"136-46"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory endovascular surgery: cost advantage and factors influencing its safe performance.","authors":"L E Shindelman,&nbsp;G B Ninnul,&nbsp;S I Curtiss,&nbsp;S F Konigsberg","doi":"10.1583/1074-6218(1999)006<0160:OAAESC>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0160:OAAESC>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a retrospective analysis of chronic limb ischemia and determine whether endovascular surgery can be performed safely and cost effectively on an ambulatory basis.</p><p><strong>Methods: </strong>Among 42 patients undergoing endovascular interventions for lower limb ischemia over a 12-month period ending October 1997, 32 (18 men, mean age 68 years, range 44 to 89) were treated solely by endovascular interventions. These patients were grouped according to time inhospital: 20 (63%) patients had endovascular procedures performed on an ambulatory basis, 7 (22%) were hospitalized for > 24 hours, and 5 (16%) required an overnight stay. The angioplasty procedures, which included placement of 21 stents, were performed in the abdominal aorta (n = 1) and the common iliac (n = 9), external iliac (n =7), superficial femoral (n = 11), popliteal (n = 5), tibioperoneal (n = 7), and subclavian (n = 1) arteries. Hospital charges were compared for the 3 groups.</p><p><strong>Results: </strong>Other than the presence of coronary artery disease, there were no significant differences in demographics or risk factors among the 3 groups. Angioplasty was technically successful in all patients, and there were no procedural complications. Patients with tissue loss required hospitalization more frequently compared to those with claudication. Significantly more patients who were hospitalized had epidural anesthesia as opposed to local when compared to the ambulatory group, 43% versus 5%, respectively (p = 0.04). Excluding professional fees, mean total hospital cost differed significantly between the ambulatory group and the group of patients with a hospital stay > 24 hours ($8227 versus $40,383, respectively; p = 0.03) and between the 2 hospitalized groups ($9476 for overnight stay versus $40,383 for > 24-hour stay, p = 0.03).</p><p><strong>Conclusions: </strong>Peripheral endovascular interventions can be performed safely on an ambulatory basis resulting in decreased hospital cost. Patients who receive epidural anesthesia, require concomitant open vascular reconstruction, present with tissue loss, or have unstable medical conditions are more likely to require hospitalization.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"160-7"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular repair of abdominal aortic aneurysm using the EVT device: limited increased utilization with availability of a bifurcated graft.","authors":"R Sarkar,&nbsp;W S Moore,&nbsp;W J Quiñones-Baldrich,&nbsp;A S Gomes","doi":"10.1583/1074-6218(1999)006<0131:EROAAA>2.0.CO;2","DOIUrl":"https://doi.org/10.1583/1074-6218(1999)006<0131:EROAAA>2.0.CO;2","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if the availability of a bifurcated graft would increase the percentage of patients eligible for endovascular repair of abdominal aortic aneurysms (AAAs).</p><p><strong>Methods: </strong>One hundred eighty-five consecutive patients were evaluated prospectively for endovascular AAA repair at a university referral center. Data were collected on eligibility for tube or bifurcated endovascular grafts, reasons for exclusion, aneurysm morphology, and the interventions performed.</p><p><strong>Results: </strong>Forty-six (25%) patients were eligible for endovascular treatment using the first-generation Endovascular Technologies (EVT) system: 19 (10%) for a tube graft and 27 (15%) for a bifurcated device. An unsuitable proximal neck was the reason for exclusion in 48% of patients (excess diameter in 27%, inadequate length in 21%). Unsuitable iliac configuration was present in 41% of those excluded; 29% of the common iliac arteries were enlarged or aneurysmal, while 12% were small or tortuous.</p><p><strong>Conclusions: </strong>Although a bifurcated graft more than doubles the eligibility of AAA patients for endovascular repair, the configuration of the proximal neck and iliac disease excluded the majority of AAA patients from endovascular therapy using the first generation EVT device.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":"6 2","pages":"131-5"},"PeriodicalIF":0.0,"publicationDate":"1999-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21337983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}