Aortic Stent Grafting

Percutaneous and Surgical Approaches
  • Omaida C. Velazquez
  • Edward Woo
  • Ronald M. Fairman
Part of the Contemporary Cardiology book series (CONCARD)


Parodi published the first series of abdominal aortic aneurysms repaired using endovascular techniques (1). Since then, the field of aortic aneurysm treatment has been revolutionized by fast technological advancements in catheter-based covered stent-grafts. In the United States, clinical studies began only a few years after Parodi’s pioneering work (2,3) and trials have progressed rapidly since then, fueled by industry support and cheered by both physicians and patients. To date, four devices have been approved by the Food and Drug Administration (FDA) (Ancure, Guidant/EVT, Menlo Park, CA; AneuRx, Medtronics, Santa Rosa, CA; Excluder, W.L. Gore & Associates, Flagstaff, AZ; Zenith, Cook, Bloomington, IN). One of the four (Ancure) has been withdrawn from the market by Guidant. In addition, numerous other devices are currently undergoing clinical trials. The FDA-approved devices can be used for the abdominal aorta, but ongoing trials are exploring the use of similar endovascular technologies for aneurysms of the thoracic aorta. Currently, a length of at least 15 mm for the proximal aortic neck and a 20-mm-long landing zone in the common iliac arteries away from any major named arterial branch are a prerequisite for being able to exclude an aneurysm by endovascular approaches. However, ongoing experimental techniques continue to push the frontiers of the endovascular approach by attempting to design ways in which one can maneuver around aortic branches, move them out of the way, or reconstruct stent-graft branches as part of the repair. Similarly, although currently a femoral cut-down is routinely used for endovascular aneurysm exclusion, the frontier of completely percutaneous aneurysm repair is actively being sought by numerous investigators and industry bioengineers. Currently, despite some early setbacks and still evolving technology, commercially manufactured endovascular systems are employed to treat abdominal aortic aneurysms (AAAs) in about 50% of elective aneurysm repairs and are continuing to spread widely throughout the world (4).


Aortic Aneurysm Iliac Artery Abdominal Aortic Aneurysm Internal Iliac Artery Endovascular Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Humana Press Inc., Totowa, NJ 2005

Authors and Affiliations

  • Omaida C. Velazquez
    • 1
  • Edward Woo
    • 1
  • Ronald M. Fairman
    • 1
  1. 1.Department of SurgeryUniversity of Pennsylvania School of MedicinePhiladelphia

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