Endovascular Exclusion of Thoracoabdominal and/or Paravisceral Abdominal Aortic Aneurysm

A TAAA or PVAAA is an abnormal enlargement of the aorta, the main artery in the chest and abdomen. The standard operation for TAAA of PVAAA is performed through a long incision extending down the side of the chest and the front of the abdomen. In the standard operation, the weak area of the aorta is replaced with a fabric sleeve (graft). The investigational operation is done making small incisions in both groins and the right arm and placing a graft in the aorta through tubes that are inserted through the femoral and brachial arteries, than fastening it in position with metal springs(stents). The combination of a stent and a graft is known as a stent-graft. Compared with standard operation, the potential advantages of endovascular TAAA/PVAAA repair include less pain, less disturbance of intestinal function, a lower risk of pulmonary or cardiac complications and shorter hospital stay. The main disadvantage of endovascular TAAA/PVAAA is an unknown success rate.

Inclusion criteria

• Aortic aneurysms:

• greater than or equal to 6 cm in diameter in men,
• greater than or equal to 5.5 cm in diameter in women,
• and/or larger than 5 cm in diameter and enlarging at a rate of more than 5 mm/year,
• and/or iliac aneurysms larger than 4 cm in diameter.
• Anticipated mortality comparable to published rates with conventional surgical treatment.
• Life expectancy more than 2 years.
• Ability to give informed consent.
• Willingness to comply with follow-up schedule.
• Suitable arterial anatomy for endovascular repair.

Exclusion criteria

• Free rupture of the aneurysm.
• Pregnancy.
• Known allergy to Nitinol, stainless steel, or polyester.
• Unwillingness or inability to comply with the follow up schedule.
• Serious systemic or groin infection.
• Uncorrectable coagulopathy.