Single-center experience with the Talent LPS endograft in patients with at least 5 years of follow-up.

摘要

PURPOSE: To evaluate long-term results in patients undergoing elective endovascular aneurysm repair (EVAR) using the Talent LPS endograft to treat abdominal aortic aneurysm (AAA). METHODS: Fifty patients (49 men; median age 72 years, range 54-89) were treated electively between 1997 and 2001 with the Talent LPS endograft chosen for various anatomical reasons, including short (< or =15 mm) aortic neck (32.5%), iliac ectasia (> or =18 mm) in at least 1 iliac artery (32%), angulated (30 degrees -60 degrees ) aortic neck (16%), large (> or =28 mm) aortic neck (6%), and tapered, reversed tapered, or bulging aortic neck (14%). A quarter of patients were preoperatively classified as unfit for AAA open repair, and 58% were high risk (ASA III or IV). The primary endpoints were immediate success, aneurysm-related and non-aneurysm-related mortality, secondary interventions, graft-related complications, graft migration (> or =5 mm), and structural failure. RESULTS: Implantation success was achieved in 96% (48/50).Four (8%) patients died within 30 days; in follow-up, the mortality rate was 51% over a mean 47.7+/-27.4 months (minimum of 5 years). Aneurysm-related mortality was 12% (6/50); 3 (6%) patients were converted. The overall reintervention rate was 16% (8/50). There were 9 (18%) endoleaks in 8 patients: 4 type I (2 proximal, 2 distal), 3 type II, and 2 type III. The migration rate was 4% (1 ruptured AAA, 1 endoleak). Individual cases of graft kinking and stent fracture occurred in this series. CONCLUSION: Despite the small population, trends in our results suggest that the Talent stent-graft performs well over the long term. Surveillance, especially with regard to migration and graft integrity, remains of great importance.