Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions

M. L. Marin, F. J. Veith, Jacob Cynamon, L. A. Sanchez, R. T. Lyon, B. A. Levine, C. W. Bakal, W. D. Suggs, K. R. Wengerter, S. P. Rivers, R. E. Parsons, J. G. Yuan, R. A. Wain, T. Ohki, Alla Rozenblit, J. C. Parodi, C. F. Barker, L. J. Greenfield, K. W. Johnston

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Abstract

Objectives: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. Patients and Methods: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16 [17%]), epidural (42 [43%]), or general (38 [40%]) anesthesia. Results: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98% immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. Conclusions: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction.

Original languageEnglish (US)
Pages (from-to)449-469
Number of pages21
JournalAnnals of Surgery
Volume222
Issue number4
StatePublished - 1995

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Blood Vessels
Transplants
Aneurysm
Therapeutics
Endovascular Procedures
Limb Salvage
Aortic Aneurysm
False Aneurysm
Arteriovenous Fistula
Comorbidity
Extremities
Anesthesia
Arteries
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Marin, M. L., Veith, F. J., Cynamon, J., Sanchez, L. A., Lyon, R. T., Levine, B. A., ... Johnston, K. W. (1995). Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions. Annals of Surgery, 222(4), 449-469.

Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions. / Marin, M. L.; Veith, F. J.; Cynamon, Jacob; Sanchez, L. A.; Lyon, R. T.; Levine, B. A.; Bakal, C. W.; Suggs, W. D.; Wengerter, K. R.; Rivers, S. P.; Parsons, R. E.; Yuan, J. G.; Wain, R. A.; Ohki, T.; Rozenblit, Alla; Parodi, J. C.; Barker, C. F.; Greenfield, L. J.; Johnston, K. W.

In: Annals of Surgery, Vol. 222, No. 4, 1995, p. 449-469.

Research output: Contribution to journalArticle

Marin, ML, Veith, FJ, Cynamon, J, Sanchez, LA, Lyon, RT, Levine, BA, Bakal, CW, Suggs, WD, Wengerter, KR, Rivers, SP, Parsons, RE, Yuan, JG, Wain, RA, Ohki, T, Rozenblit, A, Parodi, JC, Barker, CF, Greenfield, LJ & Johnston, KW 1995, 'Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions', Annals of Surgery, vol. 222, no. 4, pp. 449-469.
Marin, M. L. ; Veith, F. J. ; Cynamon, Jacob ; Sanchez, L. A. ; Lyon, R. T. ; Levine, B. A. ; Bakal, C. W. ; Suggs, W. D. ; Wengerter, K. R. ; Rivers, S. P. ; Parsons, R. E. ; Yuan, J. G. ; Wain, R. A. ; Ohki, T. ; Rozenblit, Alla ; Parodi, J. C. ; Barker, C. F. ; Greenfield, L. J. ; Johnston, K. W. / Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions. In: Annals of Surgery. 1995 ; Vol. 222, No. 4. pp. 449-469.
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abstract = "Objectives: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. Patients and Methods: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16 [17{\%}]), epidural (42 [43{\%}]), or general (38 [40{\%}]) anesthesia. Results: Technical and clinical successes were achieved in 91{\%} of the patients with aneurysms, 91{\%} with occlusive lesions, and 100{\%} with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77{\%} and 95{\%}, respectively. The 18-month limb salvage rate was 98{\%} immediately after aortic aneurysm exclusion, a total of 6 (33{\%}) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10{\%} major and a 14{\%} minor complication rate. The overall 30-day mortality rate for this entire series was 6{\%}. Conclusions: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction.",
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T1 - Initial experience with transluminally placed endovascular grafts for the treatment of complex vascular lesions

AU - Marin, M. L.

AU - Veith, F. J.

AU - Cynamon, Jacob

AU - Sanchez, L. A.

AU - Lyon, R. T.

AU - Levine, B. A.

AU - Bakal, C. W.

AU - Suggs, W. D.

AU - Wengerter, K. R.

AU - Rivers, S. P.

AU - Parsons, R. E.

AU - Yuan, J. G.

AU - Wain, R. A.

AU - Ohki, T.

AU - Rozenblit, Alla

AU - Parodi, J. C.

AU - Barker, C. F.

AU - Greenfield, L. J.

AU - Johnston, K. W.

PY - 1995

Y1 - 1995

N2 - Objectives: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. Patients and Methods: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16 [17%]), epidural (42 [43%]), or general (38 [40%]) anesthesia. Results: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98% immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. Conclusions: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction.

AB - Objectives: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. Patients and Methods: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16 [17%]), epidural (42 [43%]), or general (38 [40%]) anesthesia. Results: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98% immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. Conclusions: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction.

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