Short-Term Outcome of Endovascular Repair of Aortic Aneurysms with Stent Grafts: Initial Results of the First Consecutive Series of Endovascular Aortic Repair in Iran.

Document Type : Original Article


Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran.


Background- Endovascular aortic repair (EVAR), as a new and less invasive method for treatment of
aortic aneurysms, has shown lower short term complications than routine open surgical repairs. In
this report we present our results with the first consecutive series of this technique in our patients.
Methods- From Dec. 2006, we began a prospective case series of EVAR patients for the first time in
Iran, and so far, 15 consecutive patients (1 female, 14 male) with the mean age of 66 years (range
36 to 89 years old) underwent endovascular aortic aneurysm repair (3 thoracic, 11 abdominal, 1
combined thoracic and abdominal) with Medtronic “Talent” or “Valiant” stent grafts. In-hospital
and one month follow up results are reported as short-term outcome.
Results- All 12 abdominal aorta aneurysms (AAA) were infrarenal with an acceptable proximal neck. In
eight patients, associated iliac aneurysms were seen. For 11 AAA patients, routine modular stent
grafts were used and in one case, unilateral stent graft was implanted because of difficulty of
controlateral stent graft implantation. Four thoracic aorta aneurysms (TAA) were repaired with
Valiant stent grafts. One of them was a Marfan patient with recent Bentall surgery and two were
post-surgery saccular aneurysms. In all 15 cases, stent graft implantation was done successfully. In
five cases, mild type II endoleak was seen at the end of the procedure, which was no longer
present on one month follow up. One patient had post- procedure cerebral stroke with delayed
mortality. No other major complications were seen in 1 month follow up in the other 14 cases.
Minor complications like vascular access hematoma, anemia and increased creatinine were
controlled on hospital stay period in some cases. Control CT angiography in some patients
revealed no endoleak or aneurysm enlargement and 6 and 12-month follow up assessment will be
done for mid-term results.
Conclusion- Endovascular repair of aortic aneurysm is feasible and safe for suitable cases based on both
clinical and radiologic findings. Good case selection, good device selection and suitable follow up
are the keys for success of EVAR (Iranian Heart Journal 2008; 9 (1): 6-13).


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