Evaluation of @entity1 selection guidelines for endoluminal XXXX repair with the Zenith Stent-Graft: the Australasian experience.

@entity1 @entity439 @entity1028 @entity1070
PURPOSE: To review the @entity1 selection guidelines for endovascular repair of @entity1028 ( @entity1028 ) using the Zenith Endovascular Graft and establish an order of importance for each criterion. METHODS: The Zenith Endovascular Graft Research Database was interrogated for information on 238 @entity1 (209 @entity1 ; mean age 74.9 +/- 0.9 years, range 50-94) treated with a Zenith bifurcated graft from 1994 to 1998. The common complications of endoluminal @entity1028 repair ( @entity1070 , migration, graft occlusion, graft kinking, conversion, and deployment failure) were analyzed to determine any associations with selection criteria. RESULTS: By 1998, 69% of endograft @entity1 did not meet the recommended guidelines; however, primary and secondary @entity439 exclusion rates were 87% and 94%, respectively. Over a median follow-up of 13.4 months (interquartile range 2.8-24.0), 38 (16%) @entity1 developed 28 (74%) early and 10 (26%) late type-I endoleaks. The @entity1070 rate in necks < or = 10 mm long was 57% (8/14). Endoleak was associated with a neck contour change >3 mm (p = 0.003) and neck length <20 mm (p = 0.045). The risk of proximal @entity1070 was 4 times greater if at least one of the proximal neck guidelines was breached; combined guideline deviations of "contour change and large diameter" (p = 0.0004), "contour change and short length" (p = 0.006), "large diameter and short length" (p = 0.01), and "contour change and angle" (p = 0.03) also increased the risk of @entity1070 . Endograft migration was seen in 10 (4.2%) cases; only neck diameter >28 mm (p = 0.0024) was associated with this complication. CONCLUSIONS: Proximal neck contour, length, and diameter are the most important criteria in terms of @entity1070 development. Breaching the proximal neck length criterion resulted in a 4-fold increase in @entity1070 , and combined deviations from the guidelines multiplied the effect. Necks < or = 10 mm long are unsuitable for the standard Zenith graft.
