Endovascular repair of abdominal aortic aneurysm without preoperative arteriography Mark C Wyers, MD, Mark F Fillinger, MD, Marc L Schermerhorn, MD, Richard.

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Presentation transcript:

Endovascular repair of abdominal aortic aneurysm without preoperative arteriography Mark C Wyers, MD, Mark F Fillinger, MD, Marc L Schermerhorn, MD, Richard J Powell, MD, Eva M Rzucidlo, MD, Daniel B Walsh, MD, Robert M Zwolak, MD, PhD, Jack L Cronenwett, MD Journal of Vascular Surgery Volume 38, Issue 4, Pages 730-738 (October 2003) DOI: 10.1016/S0741-5214(03)00552-4

Fig 1 Composite of preoperative and postoperative three-dimensional reconstruction and computer-aided measurement, planning, and simulation (3D-CAMPS) images and intraoperative angiograms from the same patient. A, 3-Dimensional image of infrarenal abdominal aortic aneurysm with flow channel (red), calcified plaque (white) atheroma and thrombus (yellow). B, Same view as in A, with thrombus made invisible to simulate intraoperative arteriogram. C, Intraoperative arteriogram. D, Preoperative virtual graft simulation with “reversed limb” configuration to show intentional crossing of graft limbs within the aneurysm sac. E, Intraoperative completion arteriogram. F, One-month follow-up 3D-CAMPS study. Journal of Vascular Surgery 2003 38, 730-738DOI: (10.1016/S0741-5214(03)00552-4)

Fig 2, online only Frequency of endoleak over time. Most endoleaks were type II, and tended to resolve spontaneously. *Total percentage of patients with endoleak of any type. Journal of Vascular Surgery 2003 38, 730-738DOI: (10.1016/S0741-5214(03)00552-4)

Fig 4 Freedom from secondary intervention compared with EUROSTAR registry (January 2001), comprised of a similar mix of graft types approved and not approved by the US Food and Drug Administration over a similar period of time. Journal of Vascular Surgery 2003 38, 730-738DOI: (10.1016/S0741-5214(03)00552-4)

Fig 3 Freedom from secondary intervention over time. There was a notable difference between grafts that were ultimately approved by the US Food and Drug Administration (FDA) and those that were not approved. Freedom from secondary intervention at 12 and 24 months was 96% and 95%, respectively, for endografts ultimately approved by the FDA, significantly better than for non–FDA-approved endografts. This difference is primarily attributable to the poor long-term performance of the discontinued first-generation Vanguard I graft. Journal of Vascular Surgery 2003 38, 730-738DOI: (10.1016/S0741-5214(03)00552-4)