Endovascular Abdominal Aortic Aneurysm Repair: Part I
2009; Elsevier BV; Volume: 23; Issue: 6 Linguagem: Inglês
10.1016/j.avsg.2009.03.003
ISSN1615-5947
AutoresJoseph J. Ricotta, Rafael D. Malgor, Gustavo S. Oderich,
Tópico(s)Cardiac, Anesthesia and Surgical Outcomes
ResumoEndovascular repair of infrarenal abdominal aortic aneurysms has become a well-established and safe treatment modality. Since its development in 1991 by Juan Parodi, an increasing number of procedures have been performed worldwide. The advantages of an endovascular approach include decreased blood loss, length of hospitalization, and early morbidity and mortality. Endovascular therapy is particularly well-suited for the elderly, higher-risk patient and for those with prior aortic operations. This review summarizes the world's literature to date regarding endovascular aortic aneurysm repair in table form and should serve as a practical and prompt literature search tool. Endovascular repair of infrarenal abdominal aortic aneurysms has become a well-established and safe treatment modality. Since its development in 1991 by Juan Parodi, an increasing number of procedures have been performed worldwide. The advantages of an endovascular approach include decreased blood loss, length of hospitalization, and early morbidity and mortality. Endovascular therapy is particularly well-suited for the elderly, higher-risk patient and for those with prior aortic operations. This review summarizes the world's literature to date regarding endovascular aortic aneurysm repair in table form and should serve as a practical and prompt literature search tool. IntroductionEndovascular repair has become a widely accepted treatment for abdominal aortic aneurysms. The advantages of an endovascular approach include decreased blood loss, length of hospitalization, and early morbidity and mortality. Endovascular therapy is ideally suited for the elderly, higher-risk patient and for those with prior aortic operations. Properly selected patients have a relatively low incidence of secondary problems including migration, endoleak, and sac expansion. Aneurysm rupture is uncommon in patients who adhere to follow-up surveillance.Since the first report on the use of endovascular stent grafts by Juan Parodi and associates in 1991, substantial advances have been made in every aspect of endovascular technology. Innovations in catheters, wires, balloons, stent grafts, smaller profile and rapid exchange systems, and intravascular ultrasound have been incorporated into the endovascular practice by most vascular surgeons. In the United States, there are currently five stent grafts approved by the Food and Drug Administration for treatment of abdominal aortic aneurysms: Zenith® (Cook, Bloomington, IN), Excluder® (Gore, Flagstaff, AZ), AneuRx® and Talent® (Medtronic, Sunnyvale, CA), and Powerlink® (Endologix, Irvine, CA). Anatomic limitations are similar for all devices, including the minimum proximal neck length of 1.5 cm for abdominal and 2.0 cm for thoracic aneurysms. The Talent abdominal aortic stent graft is approved for use in patients with a shorter neck length of 1 cm.In this summary, we have reviewed the world's literature regarding endovascular aneurysm repair (EVAR). For the sake of clarity, we have elected to separate our review into two sections: (1) elective EVAR for nonruptured abdominal aortic aneurysms (AAAs) and (2) EVAR for ruptured AAAs. This review will attempt to summarize all available data for elective EVAR of nonruptured AAAs in table form. The data for EVAR of ruptured AAAs will be included in a separate summary.The literature search for this review was performed using the MEDLINE and EMBASE databases focusing on keywords such as “abdominal aortic aneurysm,” “EVAR,” “endovascular,” “endograft,” and “stent graft.” This yielded an abundance of matches consisting of a few thousand papers that have been published over the past 17 years. We refined our search based on number of patients (>30 patients), rationale and design of the study, and type of study (clinical trials, mega-trials, pivotal studies) to include the most practical and current issues related to EVAR.Data extracted from selected papers were allocated as they appear in crude values or percentages. Specific keywords were used to enrich tables related to endoleak and specific complications like bowel ischemia, buttock claudication, and sexual dysfunction.We allocated information in tables regarding epidemiology (Table I), risk factors (Table II), aneurysm features (Table III), anesthesia and risk stratification (Table IV), procedure data (Table V), device and graft data (Table VI), and early and late morbidity and mortality results of EVAR including endoleak analysis, sexual dysfunction, buttock claudication, and renal failure (Table VII, Table VIII, Table IX, Table X, Table XI, Table XII, Table XIII, Table XIV, Table XV). In table XVI, we summarized the mortality and survival results from the available level I and II evidence based on multicenter trials which compared EVAR to open repair (OR). To further compare data for each specific endograft that has been tested and commercially available in the United States, we summarized the device-specific outcomes from the respective U.S. pivotal and multicenter trials with long-term results out to 5 years and compared the results for each endovascular device in Table XVII.A, Table XVII.B.Table IEpidemiologic Data (EVAR trials)ReferencesOverall incidence of AAA12-15/100,000 persons-year4Cowan Jr., J.A. Dimick J.B. Henke P.K. Rectenwald J. Stanley J.C. Upchurch Jr., G.R. Epidemiology of aortic aneurysm repair in the United States from 1993 to 2003.Ann N Y Acad Sci. 2006; 1085: 1-10Crossref PubMed Scopus (49) Google ScholarAgeMeanRange5Ruppert V. Leurs L.J. Hobo R. Buth J. Rieger J. Umscheid T. Tube stent-grafts for infrarenal aortic aneurysm: a matched-paired analysis based on EUROSTAR data.Cardiovasc Intervent Radiol. 2007; 30: 611-618Crossref PubMed Scopus (5) Google Scholar, 6Dillavou E.D. Muluk S.C. Rhee R.Y. et al.Does hostile neck anatomy preclude successful endovascular aortic aneurysm repair?.J Vasc Surg. 2003; 38: 657-663Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar, 7Wyers M.C. Fillinger M.F. Schermerhorn M.L. et al.Endovascular repair of abdominal aortic aneurysm without preoperative arteriography.J Vasc Surg. 2003; 38: 730-738Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar, 8Nordness P.J. Carter G. Tonnessen B. Charles Sternbergh 3rd, W. Money S.R. The effect of gender on early and intermediate results of endovascular aneurysm repair.Ann Vasc Surg. 2003; 17: 615-621Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar, 9Simons P. van Overhagen H. Nawijn A. Bruijninckx B. Knippenberg B. Endovascular aneurysm repair with a bifurcated endovascular graft at a primary referral center: influence of experience, age, gender, and aneurysm size on suitability.J Vasc Surg. 2003; 38: 758-761Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar, 10Elkouri S. Gloviczki P. McKusick M.A. et al.Perioperative complications and early outcome after endovascular and open surgical repair of abdominal aortic aneurysms.J Vasc Surg. 2004; 39: 497-505Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar, 11Zeebregts C.J. Geelkerken R.H. van der Palen J. Huisman A.B. de Smit P. van Det R.J. Outcome of abdominal aortic aneurysm repair in the era of endovascular treatment.Br J Surg. 2004; 91: 563-568Crossref PubMed Scopus (22) Google Scholar, 12Biebl M. Hakaim A.G. Oldenburg W.A. et al.Midterm results of a single-center experience with commercially available devices for endovascular aneurysm repair. Mt.Sinai J Med. 2005; 72: 127-135PubMed Google Scholar, 13Biebl M. Lau L.L. Hakaim A.G. et al.Midterm outcome of endovascular abdominal aortic aneurysm repair in octogenarians: a single institution's experience.J Vasc Surg. 2004; 40: 435-442Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar, 14Garcia-Madrid C. Josa M. Riambau V. Mestres C.A. Muntana J. Mulet J. Endovascular versus open surgical repair of abdominal aortic aneurysm: a comparison of early and intermediate results in patients suitable for both techniques.Eur J Vasc Endovasc Surg. 2004; 28: 365-372Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar, 15Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial.Lancet. 2005; 365: 2179-2186Abstract Full Text Full Text PDF PubMed Scopus (786) Google Scholar, 16Rigberg D.A. Dorafshar A. Sridhar A. Quinones-Baldrich W. Moore W.S. Abdominal aortic aneursym: stent graft vs clinical pathway for direct retroperitoneal repair.Arch Surg. 2004; 139: 941-946Crossref PubMed Scopus (12) Google Scholar, 17Tefera G. Carr S.C. Turnipseed W.D. Endovascular aortic repair or minimal incision aortic surgery: which procedure to choose for treatment of high-risk aneurysms?.Surgery. 2004; 136: 748-753Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar, 18Angle N. Dorafshar A.H. Moore W.S. et al.Open versus endovascular repair of abdominal aortic aneurysms: what does each really cost?.Ann Vasc Surg. 2004; 18: 612-618Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar, 19Cao P. Verzini F. Parlani G. et al.Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair.J Vasc Surg. 2004; 40: 841-848Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar, 20Leon Jr., L.R. Labropoulos N. Laredo J. Rodriguez H.E. Kalman P.G. To what extent has endovascular aneurysm repair influenced abdominal aortic aneurysm management in the state of Illinois?.J Vasc Surg. 2005; 41: 568-574Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar, 21Thomas S.M. Beard J.D. Ireland M. Ayers S. Results from the prospective registry of endovascular treatment of abdominal aortic aneurysms (RETA): mid term results to five years.Eur J Vasc Endovasc Surg. 2005; 29: 563-570Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar, 22Zarins C.K. Crabtree T. Arko F.R. et al.Endovascular repair or surveillance of patients with small AAA.Eur J Vasc Endovasc Surg. 2005; 29: 496-504Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar, 23Azizzadeh A. Sanchez L.A. Rubin B.G. et al.Aortic neck attachment failure and the AneuRx graft: incidence, treatment options, and early results.Ann Vasc Surg. 2005; 19: 516-521Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar, 24Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial.Lancet. 2005; 365: 2187-2192Abstract Full Text Full Text PDF PubMed Scopus (382) Google Scholar, 25Lifeline registry of endovascular aneurysm repair: long-term primary outcome measures.J Vasc Surg. 2005; 42: 1-10Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar, 26Aarts F. van Sterkenburg S. Blankensteijn J.D. Endovascular aneurysm repair versus open aneurysm repair: comparison of treatment outcome and procedure-related reintervention rate.Ann Vasc Surg. 2005; 19: 699-704Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar, 27Tonnessen B.H. Sternbergh 3rd, W.C. Money S.R. Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: a comparison of AneuRx and Zenith endografts.J Vasc Surg. 2005; 42: 392-401Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar, 28Verhoeven E.L. Cina C.S. Tielliu I.F. et al.Local anesthesia for endovascular abdominal aortic aneurysm repair.J Vasc Surg. 2005; 42: 402-409Abstract Full Text Full Text PDF PubMed Scopus (64) Google Scholar, 29Hayter C.L. Bradshaw S.R. Allen R.J. Guduguntla M. Hardman D.T. Follow-up costs increase the cost disparity between endovascular and open abdominal aortic aneurysm repair.J Vasc Surg. 2005; 42: 912-918Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar, 30Parmer S.S. Carpenter J.P. Endovascular aneurysm repair with suprarenal vs infrarenal fixation: a study of renal effects.J Vasc Surg. 2006; 43: 19-25Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar, 31Bush R.L. Johnson M.L. Collins T.C. et al.Open versus endovascular abdominal aortic aneurysm repair in VA hospitals.J Am Coll Surg. 2006; 202: 577-587Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar, 32Sicard G.A. Zwolak R.M. Sidawy A.N. White R.A. Siami F.S. Endovascular abdominal aortic aneurysm repair: long-term outcome measures in patients at high-risk for open surgery.J Vasc Surg. 2006; 44: 229-236Abstract Full Text Full Text PDF PubMed Scopus (111) Google Scholar, 33Seriki D.M. Ashleigh R.J. Butterfield J.S. et al.Midterm follow-up of a single-center experience of endovascular repair of abdominal aortic aneurysms with use of the Talent stent-graft.J Vasc Interv Radiol. 2006; 17: 973-977Abstract Full Text Full Text PDF PubMed Google Scholar, 34Baril D.T. Palchik E. Carroccio A. et al.Experience with endovascular abdominal aortic aneurysm repair in nonagenarians.J Endovasc Ther. 2006; 13: 330-337Crossref PubMed Scopus (16) Google Scholar, 35Brewster D.C. Jones J.E. Chung T.K. et al.Long-term outcomes after endovascular abdominal aortic aneurysm repair: the first decade.Ann Surg. 2006; 244: 426-438PubMed Google Scholar, 36Chan Y.C. Morales J.P. Gulamhuseinwala N. et al.Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair—single centre experience.Int J Clin Pract. 2007; 61: 373-378Crossref PubMed Scopus (4) Google Scholar, 37Chahwan S. Comerota A.J. Pigott J.P. Scheuermann B.W. Burrow J. Wojnarowski D. Elective treatment of abdominal aortic aneurysm with endovascular or open repair: the first decade.J Vasc Surg. 2007; 45: 258-262Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar, 38Qu L. Hetzel G. Raithel D. Seven years' single center experience of Powerlink unibody bifurcated endograft for endovascular aortic aneurysm repair.J Cardiovasc Surg (Torino). 2007; 48: 13-19PubMed Google Scholar, 39Boult M. Maddern G. Barnes M. Fitridge R. Factors affecting survival after endovascular aneurysm repair: results from a population based audit.Eur J Vasc Endovasc Surg. 2007; 34: 156-162Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar, 40Hugl B. Hakaim A.G. Biebl M. et al.Impact of gender on the outcome of endovascular aortic aneurysm repair using the Zenith stent-graft: midterm results.J Endovasc Ther. 2007; 14: 115-121Crossref PubMed Scopus (12) Google Scholar, 41Waasdorp E. van't Hullenaar C. van Herwaarden J. et al.Renal function after endovascular aortic aneurysm repair: a single-center experience with transrenal versus infrarenal fixation.J Endovasc Ther. 2007; 14: 130-137Crossref PubMed Scopus (13) Google Scholar, 42van Herwaarden J.A. van de Pavoordt E.D. Waasdorp E.J. et al.Long-term single-center results with AneuRx endografts for endovascular abdominal aortic aneurysm repair.J Endovasc Ther. 2007; 14: 307-317Crossref PubMed Scopus (25) Google Scholar, 43Gawenda M. Brunkwall J. Renal response to open and endovascular repair of abdominal aortic aneurysm: a prospective study.Ann Vasc Surg. 2008; 22: 1-4Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar, 54Woodburn K.R. Chant H. Davies J.N. Blanshard K.S. Travis S.J. Suitability for endovascular aneurysm repair in an unselected population.Br J Surg. 2001; 88: 77-81Crossref PubMed Scopus (54) Google Scholar73.7 yr(47-98)GenderMale: Female ratio5Ruppert V. Leurs L.J. Hobo R. Buth J. Rieger J. Umscheid T. Tube stent-grafts for infrarenal aortic aneurysm: a matched-paired analysis based on EUROSTAR data.Cardiovasc Intervent Radiol. 2007; 30: 611-618Crossref PubMed Scopus (5) Google Scholar, 6Dillavou E.D. Muluk S.C. Rhee R.Y. et al.Does hostile neck anatomy preclude successful endovascular aortic aneurysm repair?.J Vasc Surg. 2003; 38: 657-663Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar, 7Wyers M.C. Fillinger M.F. Schermerhorn M.L. et al.Endovascular repair of abdominal aortic aneurysm without preoperative arteriography.J Vasc Surg. 2003; 38: 730-738Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar, 8Nordness P.J. Carter G. Tonnessen B. Charles Sternbergh 3rd, W. Money S.R. The effect of gender on early and intermediate results of endovascular aneurysm repair.Ann Vasc Surg. 2003; 17: 615-621Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar, 9Simons P. van Overhagen H. Nawijn A. Bruijninckx B. Knippenberg B. Endovascular aneurysm repair with a bifurcated endovascular graft at a primary referral center: influence of experience, age, gender, and aneurysm size on suitability.J Vasc Surg. 2003; 38: 758-761Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar, 10Elkouri S. Gloviczki P. McKusick M.A. et al.Perioperative complications and early outcome after endovascular and open surgical repair of abdominal aortic aneurysms.J Vasc Surg. 2004; 39: 497-505Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar, 11Zeebregts C.J. Geelkerken R.H. van der Palen J. Huisman A.B. de Smit P. van Det R.J. Outcome of abdominal aortic aneurysm repair in the era of endovascular treatment.Br J Surg. 2004; 91: 563-568Crossref PubMed Scopus (22) Google Scholar, 12Biebl M. Hakaim A.G. Oldenburg W.A. et al.Midterm results of a single-center experience with commercially available devices for endovascular aneurysm repair. Mt.Sinai J Med. 2005; 72: 127-135PubMed Google Scholar, 13Biebl M. Lau L.L. Hakaim A.G. et al.Midterm outcome of endovascular abdominal aortic aneurysm repair in octogenarians: a single institution's experience.J Vasc Surg. 2004; 40: 435-442Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar, 14Garcia-Madrid C. Josa M. Riambau V. Mestres C.A. Muntana J. Mulet J. Endovascular versus open surgical repair of abdominal aortic aneurysm: a comparison of early and intermediate results in patients suitable for both techniques.Eur J Vasc Endovasc Surg. 2004; 28: 365-372Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar, 15Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial.Lancet. 2005; 365: 2179-2186Abstract Full Text Full Text PDF PubMed Scopus (786) Google Scholar, 16Rigberg D.A. Dorafshar A. Sridhar A. Quinones-Baldrich W. Moore W.S. Abdominal aortic aneursym: stent graft vs clinical pathway for direct retroperitoneal repair.Arch Surg. 2004; 139: 941-946Crossref PubMed Scopus (12) Google Scholar, 17Tefera G. Carr S.C. Turnipseed W.D. Endovascular aortic repair or minimal incision aortic surgery: which procedure to choose for treatment of high-risk aneurysms?.Surgery. 2004; 136: 748-753Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar, 18Angle N. Dorafshar A.H. Moore W.S. et al.Open versus endovascular repair of abdominal aortic aneurysms: what does each really cost?.Ann Vasc Surg. 2004; 18: 612-618Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar, 19Cao P. Verzini F. Parlani G. et al.Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair.J Vasc Surg. 2004; 40: 841-848Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar, 20Leon Jr., L.R. Labropoulos N. Laredo J. Rodriguez H.E. Kalman P.G. To what extent has endovascular aneurysm repair influenced abdominal aortic aneurysm management in the state of Illinois?.J Vasc Surg. 2005; 41: 568-574Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar, 21Thomas S.M. Beard J.D. Ireland M. Ayers S. Results from the prospective registry of endovascular treatment of abdominal aortic aneurysms (RETA): mid term results to five years.Eur J Vasc Endovasc Surg. 2005; 29: 563-570Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar, 22Zarins C.K. Crabtree T. Arko F.R. et al.Endovascular repair or surveillance of patients with small AAA.Eur J Vasc Endovasc Surg. 2005; 29: 496-504Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar, 23Azizzadeh A. Sanchez L.A. Rubin B.G. et al.Aortic neck attachment failure and the AneuRx graft: incidence, treatment options, and early results.Ann Vasc Surg. 2005; 19: 516-521Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar, 24Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial.Lancet. 2005; 365: 2187-2192Abstract Full Text Full Text PDF PubMed Scopus (382) Google Scholar, 25Lifeline registry of endovascular aneurysm repair: long-term primary outcome measures.J Vasc Surg. 2005; 42: 1-10Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar, 26Aarts F. van Sterkenburg S. Blankensteijn J.D. Endovascular aneurysm repair versus open aneurysm repair: comparison of treatment outcome and procedure-related reintervention rate.Ann Vasc Surg. 2005; 19: 699-704Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar, 27Tonnessen B.H. Sternbergh 3rd, W.C. Money S.R. Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: a comparison of AneuRx and Zenith endografts.J Vasc Surg. 2005; 42: 392-401Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar, 28Verhoeven E.L. Cina C.S. Tielliu I.F. et al.Local anesthesia for endovascular abdominal aortic aneurysm repair.J Vasc Surg. 2005; 42: 402-409Abstract Full Text Full Text PDF PubMed Scopus (64) Google Scholar, 29Hayter C.L. Bradshaw S.R. Allen R.J. Guduguntla M. Hardman D.T. Follow-up costs increase the cost disparity between endovascular and open abdominal aortic aneurysm repair.J Vasc Surg. 2005; 42: 912-918Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar, 30Parmer S.S. Carpenter J.P. Endovascular aneurysm repair with suprarenal vs infrarenal fixation: a study of renal effects.J Vasc Surg. 2006; 43: 19-25Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar, 31Bush R.L. Johnson M.L. Collins T.C. et al.Open versus endovascular abdominal aortic aneurysm repair in VA hospitals.J Am Coll Surg. 2006; 202: 577-587Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar, 32Sicard G.A. Zwolak R.M. Sidawy A.N. White R.A. Siami F.S. Endovascular abdominal aortic aneurysm repair: long-term outcome measures in patients at high-risk for open surgery.J Vasc Surg. 2006; 44: 229-236Abstract Full Text Full Text PDF PubMed Scopus (111) Google Scholar, 33Seriki D.M. Ashleigh R.J. Butterfield J.S. et al.Midterm follow-up of a single-center experience of endovascular repair of abdominal aortic aneurysms with use of the Talent stent-graft.J Vasc Interv Radiol. 2006; 17: 973-977Abstract Full Text Full Text PDF PubMed Google Scholar, 34Baril D.T. Palchik E. Carroccio A. et al.Experience with endovascular abdominal aortic aneurysm repair in nonagenarians.J Endovasc Ther. 2006; 13: 330-337Crossref PubMed Scopus (16) Google Scholar, 35Brewster D.C. Jones J.E. Chung T.K. et al.Long-term outcomes after endovascular abdominal aortic aneurysm repair: the first decade.Ann Surg. 2006; 244: 426-438PubMed Google Scholar, 36Chan Y.C. Morales J.P. Gulamhuseinwala N. et al.Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair—single centre experience.Int J Clin Pract. 2007; 61: 373-378Crossref PubMed Scopus (4) Google Scholar, 37Chahwan S. Comerota A.J. Pigott J.P. Scheuermann B.W. Burrow J. Wojnarowski D. Elective treatment of abdominal aortic aneurysm with endovascular or open repair: the first decade.J Vasc Surg. 2007; 45: 258-262Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar, 38Qu L. Hetzel G. Raithel D. Seven years' single center experience of Powerlink unibody bifurcated endograft for endovascular aortic aneurysm repair.J Cardiovasc Surg (Torino). 2007; 48: 13-19PubMed Google Scholar, 39Boult M. Maddern G. Barnes M. Fitridge R. Factors affecting survival after endovascular aneurysm repair: results from a population based audit.Eur J Vasc Endovasc Surg. 2007; 34: 156-162Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar, 40Hugl B. Hakaim A.G. Biebl M. et al.Impact of gender on the outcome of endovascular aortic aneurysm repair using the Zenith stent-graft: midterm results.J Endovasc Ther. 2007; 14: 115-121Crossref PubMed Scopus (12) Google Scholar, 41Waasdorp E. van't Hullenaar C. van Herwaarden J. et al.Renal function after endovascular aortic aneurysm repair: a single-center experience with transrenal versus infrarenal fixation.J Endovasc Ther. 2007; 14: 130-137Crossref PubMed Scopus (13) Google Scholar, 42van Herwaarden J.A. van de Pavoordt E.D. Waasdorp E.J. et al.Long-term single-center results with AneuRx endografts for endovascular abdominal aortic aneurysm repair.J Endovasc Ther. 2007; 14: 307-317Crossref PubMed Scopus (25) Google Scholar, 43Gawenda M. Brunkwall J. Renal response to open and endovascular repair of abdominal aortic aneurysm: a prospective study.Ann Vasc Surg. 2008; 22: 1-4Abstract Full Text Full Text PDF PubMed Scopus (11) Google ScholarAverage: 6:1(49031 males/8556 females) Open table in a new tab Table IIRisk FactorsIncidenceRisk FactorRangeAverage(n)ReferencesChronic Renal Failure3-38%6% (1023/16926)5Ruppert V. Leurs L.J. Hobo R. Buth J. Rieger J. Umscheid T. Tube stent-grafts for infrarenal aortic aneurysm: a matched-paired analysis based on EUROSTAR data.Cardiovasc Intervent Radiol. 2007; 30: 611-618Crossref PubMed Scopus (5) Google Scholar, 8Nordness P.J. Carter G. Tonnessen B. Charles Sternbergh 3rd, W. Money S.R. The effect of gender on early and intermediate results of endovascular aneurysm repair.Ann Vasc Surg. 2003; 17: 615-621Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar, 10Elkouri S. Gloviczki P. McKusick M.A. et al.Perioperative complications and early outcome after endovascular and open surgical repair of abdominal aortic aneurysms.J Vasc Surg. 2004; 39: 497-505Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar, 12Biebl M. Hakaim A.G. Oldenburg W.A. et al.Midterm results of a single-center experience with commercially available devices for endovascular aneurysm repair. Mt.Sinai J Med. 2005; 72: 127-135PubMed Google Scholar, 13Biebl M. Lau L.L. Hakaim A.G. et al.Midterm outcome of endovascular abdominal aortic aneurysm repair in octogenarians: a single institution's experience.J Vasc Surg. 2004; 40: 435-442Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar, 14Garcia-Madrid C. Josa M. Riambau V. Mestres C.A. Muntana J. Mulet J. Endovascular versus open surgical repair of abdominal aortic aneurysm: a comparison of early and intermediate results in patients suitable for both techniques.Eur J Vasc Endovasc Surg. 2004; 28: 365-372Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar, 19Cao P. Verzini F. Parlani G. et al.Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair.J Vasc Surg. 2004; 40: 841-848Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar, 25Lifeline registry of endovascular aneurysm repair: long-term primary outcome measures.J Vasc Surg. 2005; 42: 1-10Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar, 28Verhoeven E.L. Cina C.S. Tielliu I.F. et al.Local anesthesia for endovascular abdominal aortic aneurysm repair.J Vasc Surg. 2005; 42: 402-409Abstract Full Text Full Text PDF PubMed Scopus (64) Google Scholar, 29Hayter C.L. Bradshaw S.R. Allen R.J. Guduguntla M. Hardman D.T. 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