Long-term surveillance is paramount after implantation of the Vanguard stent-graft for abdominal aortic aneurysms

Aim The aim of this study was to describe the results and long-term follow-up of the Vanguard endovascular graft for infrarenal abdominal aortic aneurysm (AAA) repair. Methods. Between February 1997 and October 1999, 76 patients were treated with a median aneurysm diameter of 52 mm (39-90 mm). All were followed up according to the Eurostar criteria. Results. The primary technical success rate was 100%. Perioperative mortality was 1.3%. During follow-up (median 75 months, 6-112 months) 9 aneurysm related deaths occurred. A total of 79 late complications occurred in 45 patients (64%). Complications were noticed more frequently in the group of aneurysms larger than 5.5 cm (P=0.014). Patients who ultimately developed aneurysm rupture after endovascular repair had more postoperative complications compared to the majority who did not rupture their aneurysm. (P=0.001) Secondary interventions were mandatory in 23 patients, surgical conversion in 9. At 72 months this has resulted in an overall survival rate of 57%, an aneurysm rupture free survival of 88%, a conversion free survival of 95%, an endoleak free survival of 83% and a secondary intervention free survival of 82% (Kaplan Maier). Conclusion. The importance of life-long strict surveillance of patients treated with a Vanguard endograft was confirmed. Patients with graft-related complications should be treated accordingly.