Endovascular repair of abdominal aortic aneurysms using the EGS tube and bifurcated graft systems

Left untreated, aneurysmal disease of the abdominal aorta is a highly lethal condition. Standard transabdominal repair of aortic aneurysm, although successful and durable, continues to be plagued by significant morbidity, mortality, and cost. Placement of an endovascular graft through a femoral arteriotomy is a new technique that could potentially reduced this morbidity and cost without sacrificing efficacy. This report details the development of a U.S. Food and Drug Administration (FDA)-approved endovascular grafting device. In addition, we describe our experience screening patients and summarize our clinical experience with the placement of both tube and bifurcated endovascular graft systems. To date, 16 patients have undergone endovascular repair with a tube graft at UCLA, and three bifurcated grafts have been placed. Two patients required conversion to conventional open aneurysm repair. All the remaining procedures were successful, and there were no perioperative deaths or major complications. We conclude that endovascular grafting of aortic aneurysms is both feasible and safe. Long-term patency and the ability of this technique to prevent the known complications of aortic aneurysmal disease remain unanswered questions at this time.