Endovascular Devices for Abdominal Aortic Aneurysms

  • Arash Keyhani
  • Rodney A. White


The field of vascular surgery entered an era of change with the introduction of stent graft for the repair of the abdominal aortic aneurysm (AAA). The first reported case by Dr. Parodi in 1991 sparked an interest in minimal invasive, catheter-driven therapeutic intervention of high-risk patients [1, 2]. The early grafts were physician-made devices employing available stents and vascular graft material. These prototypes were aortic–aortic tube grafts made to treat aneurysms with proximal and distal aortic fixation. The technology limited the number of qualified aortic anatomies suitable for these devices. Nevertheless, these first-generation devices only proved effective in short-term treatment of aneurysms as there was up to a 12% delayed aneurysm rupture within 72 months [3]. This eventually led to the formation of bifurcated devices and modular systems with iliac sealing zones, thus expanding the number of patients that could be treated. Endovascular aortic aneurysm repair (EVAR) did not reach center stage until 1999 when the Food and Drug Administration (FDA) granted approval for two industry-made devices for clinical use (AneuRx and Ancure). These second-generation endografts were designed to improve fixation and sealing leading to the improved outcome of EVAR.


abdominal aortic aneurysm devices for abdominal aortic aneurysm future of endograft technology 


  1. 1.
    Parodi JC, Palmaz JC, Barone HD: Transfemoral intraluminal graft implantation for abdominal aortic aneurysms, Ann Vas Surg 5:491, 1991.CrossRefGoogle Scholar
  2. 2.
    Parodi JC, Marin ML, Veith FJ: Transfemoral endovascular stented graft repair of an abdominal aortic aneurysm, Arch Surg 130:549, 1995.PubMedCrossRefGoogle Scholar
  3. 3.
    Harris PL, Vallabhanensi SR, Desgranges P et al.: Incidence and risk factors of late rupture conversion and death after endovascular repair of infrarenal aortic aneurysm: EUROSTAR experience, J Vasc Surg 32:739–749, 2000.PubMedCrossRefGoogle Scholar
  4. 4.
    Sternbergh WC, Carter G, York JW et al.: Aortic neck angulation predict adverse outcome with endovascular abdominal aortic aneurysm repair, J Vasc Surg 35:482–486, 2002.PubMedCrossRefGoogle Scholar
  5. 5.
    Boult M, Babidge W, Maddern G et al.: Predictors of success following endovascular aneurysm repair: mid-term results, Eur J Vasc Endovasc Surg 31:123–129, 2006.PubMedCrossRefGoogle Scholar
  6. 6.
    Gitlitz DB, Ramaswami G, Kaplan D et al.: Endovascular stent-grafting in the presence of aortic neck filling defects: early clinical experience, J Vasc Surg 33:340–344, 2001.PubMedCrossRefGoogle Scholar
  7. 7.
    Benharash P, Lee JT, Abilez OJ et al.: Iliac fixation inhibits both suprarenal and infrarenal aortic neck grafts, J Vas Surg 45:250–257, 2007.CrossRefGoogle Scholar
  8. 8.
    Karmacharya J, Parmer SS, Antezana JN et al.: Outcomes of accessory renal artery exclusion during endovascular aneurysm repair, J Vasc Surg 43(1):8–13, 2006.PubMedCrossRefGoogle Scholar
  9. 9.
    Zarins CK, White RA, Hodgson KJ et al., for the AneuRx Clinical Investigators: Endoleak as a predictor of outcome following endovascular aneurysm repair. AneuRx multicenter clinical trial, J Vasc Surg 32:90–107, 2002.CrossRefGoogle Scholar
  10. 10.
    Zarins CK, Bloch DA, Crabtree T et al.: Stent graft migration after endovascular aneurysm repair: importance of proximal fixation, J Vasc Surg 38:1264–1271, 2003.PubMedCrossRefGoogle Scholar
  11. 11.
    Greenberg RK, Chuter TA, Cambria R et al.: Zenith abdominal aortic aneurysm endovascular graft, J Vasc Surg 48:1–9, 2008.PubMedCrossRefGoogle Scholar
  12. 12.
    Greenberg RK, Chuter TA, Sternbergh WC et al.: Zenith AAA endovascular graft: intermediate-terms results of US multicenter trial, J Vasc Surg 39:1209–1218, 2004.PubMedCrossRefGoogle Scholar
  13. 13.
    Carpenter JP, the Endologix Investigators: Midterm results of the multicenter trial of the Powerlink bifurcated system for endovascular aortic aneurysm repair, J Vasc Surg 48:535–545, 2008.PubMedCrossRefGoogle Scholar
  14. 14.
    Qu L, Raithel D: From clinical trials to clinical practice: 612 cases treated with the Powerlink stent-graft for endovascular repair of AAA, J Cardiovasc Surg 50:131–137, 2009.Google Scholar
  15. 15.
    Fillinger M, for the Excluder Bifurcated Endoprosthesis Clinical Investigators: Three-dimensional analysis of enlarging aneurysms after endovascular abdominal aortic aneurysm repair in the Gore Excluder Pivotal clinical trial, J Vasc Surg 43:888–895, 2006.PubMedCrossRefGoogle Scholar
  16. 16.
    Tanski W, Fillinger M: Outcomes of original and low-permeability Gore excluder endoprosthesis for endovascular abdominal aortic aneurysm repair, J Vasc Surg 45:243–249, 2007.PubMedCrossRefGoogle Scholar
  17. 17.
    Torsello G, Osada N, Florek HJ et al.: Long-term outcome after Talent endograft implantation from aneurysms of the abdominal aorta: A multicenter retrospective study, J Vasc Surg 43:277–284, 2006.PubMedCrossRefGoogle Scholar
  18. 18.
    Balasubramaniam K, Hardman J, Horrocks M et al.: The advantage of Aorfix for endovascular repair of abdominal aortic aneurysm, J Cardiovasc Surg 50:139–143, 2009.Google Scholar
  19. 19.
    Verhagen HJM, Torsello G, Vries JP et al.: Endurant stent-graft system: preliminary report on an innovative treatment for challenging abdominal aortic aneurysm, J Cardiovasc Surg 50:153–158, 2009.Google Scholar
  20. 20.
    Patterson BO, Holt PJ, Hinchliffe R et al.: Predicting risk in elective abdominal aortic aneurysm repair: a systematic review of current evidence, Eur J Vasc Endovasc Surg 36:637–645, 2008.PubMedCrossRefGoogle Scholar
  21. 21.
    Stella A, Freyrie A, Gargiulo M et al.: The advantages of Anaconda endograft for AAA, J Cardiovasc Surg 50:145–152, 2009.Google Scholar
  22. 22.
    Donayre C, Kopchok GE, White RA: Fillable endovascular aneurysm repair, EV Today 8:64–66, 2009.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Arash Keyhani
    • 1
  • Rodney A. White
    • 2
  1. 1.Department of Vascular SurgeryHarbour-UCLA Medical CenterTorranceUSA
  2. 2.Vascular SurgeryLos Angeles County Harbor-UCLA Medical CenterTorranceUSA

Personalised recommendations