AAA: Endovascular Repair -1
We have been involved in the endovascular treatment of abdominal aortic aneurysms for approximately five years. We have used most of the first generation devices and are now using the recently released GORE EXCLUDER ENDO-PROSTHESIS. It has been used extensively in Europe and has an excellent track record with a very low complication rate plus an excellent long- term patient survival.
All patients with the diagnosis of AAA can be considered for treatment using the endovascular stent graft. Typically, the initial evaluation will include sizing measurements to determine if their particular anatomy lends itself to endovascular therapy. Specifically, a non-contrast CT with axial images from the diaphragm to the femoral heads or a CT Angiogram acquired at intervals of 2-3mm is needed as the initial study. Additional necessary studies also must include either a calibrated Abdominal Aortic Angiogram or CT Reconstruction that includes multiplanar reconstructions. These studies allow measurement of the aortic neck diameter, length, and angulation, the iliac artery diameter and configuration plus other pertinent anatomic information needed to determine patient suitability for endovascular treatment.
If these initial studies show suitable anatomy, cardiac clearance and assessment of other preoperative parameters is performed. Approximately 2/3 of aneurysm patients have anatomy, which is suitable for endovascular therapy. The remaining patients are considered for traditional surgical repair.
Post-operative assessment includes a CT scan or ultrasound at 3 months, at 6 months, then each year to monitor aneurysm volume loss.