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Abstract


doi: 10.1583/04-1342R.1
Journal of Endovascular Therapy: Vol. 12, No. 1, pp. 35–45.

Six-Year Experience With Talent Stent-Graft Repair of Abdominal Aortic Aneurysms

Gaudencio Espinosa, PhD1; Márcia Ribeiro, MD3; Cristina Riguetti, MD1; Monica Ferreira Caramalho, MD2; Warley Dias Siqueira Mendes, MD1; and Sergio Ricardo Santos4

1Departments of 1Vascular Surgery

2Radiology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil

3Department of Angiology, State University of Rio de Janeiro, Brazil

4Statistical and Mathematics Department, Federal University of Rio de Janeiro, Brazil



Purpose: To report a long-term experience with the Talent Endoprosthesis for the treatment of abdominal aortic aneurysm (AAA).

Methods: In the period between June 1997 and June 2003, 193 patients (171 men; mean age 71.0±7.8 years, range 52–89) with AAA were treated with a Talent Endoprosthesis. Patients were clinically and radiologically followed in the postoperative period, at 30 days, and then annually up to 72 months. In addition to computed tomographic scans, a plain abdominal radiogram was also performed annually for structural assessment of the stent-graft.

Results: Implantation success was 99.0% (191/193). Delivery system introduction was the cause of 1 failure, and the other patient was converted to surgery for intraprocedural device migration. There were 10 (5.2%) endoleaks (3 type I, 7 type II) at 30 days; all type I and 3/7 type II endoleaks were treated (93.3% secondary clinical success). Seven (3.7%) patients died in the perioperative period, including the conversion. During follow-up, 18 (9.3%) additional deaths occurred, and 4 new endoleaks (1 type I, 2 type II, 1 type III) were encountered. In up to 6 years' follow-up, the Talent Endoprosthesis did not present signs of material fatigue, but 1 component disconnection at 42 months led to death. There was no aneurysm rupture. After an initial increase in the aortic neck (1.2±1.1 mm) in the postoperative period, the neck diameters continued to increase until after the third year. An average reduction of 5.6±4.1 mm in the aneurysm diameter at 1 year was noted; the reduction gradually reached 14.1±10.7 mm after 60 months.

Conclusions: The Talent Endoprosthesis was an efficient alternative for managing AAAs, achieving low morbidity and mortality rates and a good long-term clinical outcome in this study. The Talent Endoprosthesis did not present signs of material fatigue over a 6-year follow-up.

Keywords: abdominal aortic aneurysm, endovascular repair, stent-graft, selection criteria, endoleak, proximal neck, neck diameter, sac diameter, sac volume, outcome analysis, surveillance, complications, mortality



© Copyright by International Society of Endovascular Specialists 2005