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The problem of the first generation of in-cavity aneurysm repair stents is well known, but its long-term results have yet to be determined.
to explore the prognosis for the first generation of stent implants (Vanguard) to treat patients with abdominal aortic aneurysms (AAA), researchers from Finland shared the results of a 20-year follow-up at a single center.
results of the study were published on the website of the journal Journal ofVascular Surgery on 2 March 2020.
study method, between February 1997 and November 1999, 48 AAA patients selectively received Vanguard stent implants.
patients are monitored annually until the end of 2018.
results of the study were total survival and transplant-related complications, as well as re-intervention rates.
the study was 70 years old (range 54 to 85 years old) and followed for an average of 107 months (range 6 to 262 months).
all stent implants were successful, but 90% of patients experienced stent-related complications during follow-up.
most common complications were internal leakage (27 percent for type I; 29 percent for type II; type III. 31 percent), fracture of stent (46 percent), thrombosis of the graft (31 percent) and transfer of the graft (40 percent).
40 patients (83%) needed secondary surgery during long follow-up.
84 patients (87%) successfully treated complications using in-cavity methods.
no initial conversion strategy, but 10 patients (21%) needed a late-stage conversion strategy.
in 5 cases, complications required the use of updated equipment.
AAA ruptures occurred in four cases (8.3 percent), two of which were fatal.
survival rates of 94 per cent, 69 per cent, 33 per cent, 15 per cent and 13 per cent over 1, 5, 10, 15 and 20 years, respectively.
first-generation Vanguard stent was associated with complications associated with a variety of grafts.
, however, these complications can mainly be treated by in-cavity methods.
Vanguard stent is a good example of how new technologies can cause unpredictable problems and increase workload, even decades after the initial surgery.
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