Endovascular treatment of aortic aneurysm using the Chuter device

This article assesses a system of endovascular aneurysm repair and determines its potential role in the management of abdominal aortic aneurysm (AAA). The prosthesis was a combination of woven polyester fabric and stainless steel Gianturco Z-stents. Straight (aorto-aortic), tapered (aorto-uniiliac), and bifurcated (aorto-biiliac) stent grafts have all evolved, together with the delivery systems, the patient selection criteria, and the method of insertion, since these devices were first introduced in 1991. Currently, 70% of patients are considered to have the anatomic substrate for endovascular aneurysm repair. All stent-graft implantations were performed in the operating room. Preoperative assessment and postoperative follow-up were based mainly on contrast- enhanced CT, which was performed at 3 days, 3 months, 6 months, and 12 months following repair, if the initial CT showed endoleak, CT was repeated at 2 weeks. Persistent leak at 2 weeks was investigated angiographically as the basis for endovascular intervention, following which CT was repeated again. The results of the most recent (US) experience are as follows. Between June 1996 and September 1997, 46 high-risk patients underwent elective endovascular repair of AAA under an FDA protocol. Aorto-uniiliac stent grafts were used in 38 and aorto-aortic stent grafts in the remainder. The operating time was 190 +/- 71 min (mean + standard deviation), estimated blood loss was 303 +/- 402 ml, and contrast volume was 153 +/- 70 ml. The time from operation to resumption of a normal diet was 0.58 +/- 0.58 days, to ambulation was 1.17 +/- 0.8 days, and to discharge was 3.42 +/- 1.51 days. Six patients had an endoleak on the initial CT, but only 1 of these had leakage 1 month after operation. There were no deaths and no conversions to open repair. Endovascular aneurysm re pair with this system is safe and effective in the short to medium term.