Midterm results of a single endovascular device for repair of an abdominal aortic aneurysm: one centre's experience of the Vanguard device

Background: The aim of the study was to evaluate the midterm results of the Vanguard device. Methods: All deployments performed in a single centre with follow‐up according to EUROSTAR criteria were reviewed. Results: Fifty‐five patients underwent deployment of a Vanguard device between December 1995 and July 1999. All stents were implanted successfully, with a perioperative mortality rate of 5 per cent (three of 55 patients). Twelve systemic complications (23 per cent) and three access site complications (6 per cent) were observed. Predischarge computed tomograms revealed one type I and five type II endoleaks. Eleven patients died during follow‐up (median 23·4 (range 6–48) months) (ten unrelated, one ruptured abdominal aortic aneurysm). The 2‐year survival rate was 70 per cent. Eleven occluded graft limbs (22 per cent; median onset 18 months (range from 24 h to 36 months)), one graft migration and eight late endoleaks (16 per cent; median onset 24 (range 3–42) months) were observed. The 2‐year intervention‐free survival rate was 68 per cent, with an endoleak‐free survival rate of 84 per cent. Median (range) neck diameter increased from 20 (15–23) to 23 (17–27) mm at 24 months ( P < 0·01). Conclusion: The onset of late endoleak and limb occlusion suggests that follow‐up is essential, even after 36 months. The increasing neck diameter may prove significant with regard to long‐term fixation of the proximal device. © 2001 British Journal of Surgery Society Ltd