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Should Endovascular Repair Be Used for Small Abdominal Aortic Aneurysms?

Section of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama

Marc A. Passman, MD

Section of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama, Marc.Passman{at}ccc.uab.edu

Steven M. Taylor, MD

Section of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama

Mark A. Patterson, MD

Section of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama

Bart R. Combs, MD

Section of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama

William D. Jordan, Jr, MD

Section of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama

The outcomes of endovascular repair for small abdominal aortic aneurysm (4.0-4.9 cm) is reported. All patients undergoing endovascular abdominal aortic aneurysm repair between 2000 and 2006 with maximal diameter 4.0 to 4.9 cm form the small aneurysm study cohort. Data were analyzed retrospectively and life-table methods were used. Of 743 endovascular repairs, 132 (17.8%) were performed for small abdominal aortic aneurysm. Perioperative complication rate was 9.1%. Freedom from aneurysm expansion was 96% at 1 year, 86% at 3 years, and 77% at 5 years. Overall survival was 98%, 93%, and 84% at 1, 3, and 5 years, respectively. Perioperative 30-day mortality was 0.8% with an aneurysm-related mortality of 1.5% at 5 years. There were no deaths from delayed aneurysm rupture. Endovascular repair of small abdominal aortic aneurysm is associated with low perioperative morbidity and mortality compared with published results for open repair, and treatment threshold can be reduced to 4 cm in selected patients.

Key Words: small abdominal aortic aneurysm • endovascular repair

This version was published on May 1, 2008

Vascular and Endovascular Surgery, Vol. 42, No. 2, 113-119 (2008)
DOI: 10.1177/1538574407312656


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