Utility and reliability of endovascular aortouniiliac with femorofemoral crossover graft for aortoiliac aneurysmal disease

Thomas F. Rehring, David C. Brewster, Richard P. Cambria, John A. Kaufman, Stuart C. Geller, Chieh Min Fan, Jonathan P. Gertler, Glenn M. LaMuraglia, William M. Abbott

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50 Scopus citations

Abstract

Objective: The purpose of this study was to determine the early efficacy of endovascular aortouniiliac stent grafts with femorofemoral bypass graft in the treatment of aortoiliac aneurysmal disease. Methods: We analyzed 51 consecutive patients from January 1997 to March 1999 with a mean follow-up of 15.8 months. Patients ranged in age from 44 to 93 years (mean, 75 years) with a mean aortic aneurysm diameter of 6.2 cm. Technical success was achieved in 50 patients; one patient required conversion to open repair intraoperatively. We placed 28 custom-made and 22 commercial devices. The mean operative time was 223 minutes. The endograft was extended to the external lilac artery in 42% of cases. The contralateral common iliac artery was occluded using either a closed covered stent or intraluminal coils. Results: The median hospital stay was 4 days with an average intensive care unit stay of 0.25 days. There were no operative mortalities. Two patients died during follow-up from unrelated conditions. Endoleaks occurred in 11 patients (22%); seven patients (14%) required intervention (four catheter based, three operative). Other complications occurred in 38% of patients but were largely remote or wound related. One femorofemoral bypass graft occluded immediately postoperatively as a result of an intraprocedural external iliac dissection yielding a 98% primary patency and 100% secondary patency. Clinical success was achieved in 88% of patients. Conclusions: These data suggest that this strategy represents a reliable method of repair of aortoiliac aneurysmal disease and extends the capability of an endoluminal approach to patients with complex iliac anatomy.

Original languageEnglish (US)
Pages (from-to)1135-1141
Number of pages7
JournalJournal of vascular surgery
Volume31
Issue number6
DOIs
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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    Rehring, T. F., Brewster, D. C., Cambria, R. P., Kaufman, J. A., Geller, S. C., Fan, C. M., Gertler, J. P., LaMuraglia, G. M., & Abbott, W. M. (2000). Utility and reliability of endovascular aortouniiliac with femorofemoral crossover graft for aortoiliac aneurysmal disease. Journal of vascular surgery, 31(6), 1135-1141. https://doi.org/10.1067/mva.2000.107120