Three-year experience with the White-Yu Endovascular GAD Graft for transluminal repair of aortic and iliac aneurysms

G. H. White*, W. Yu, J. May, R. Waugh, X. Chaufour, J. P. Harris, M. S. Stephen

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    109 Citations (Scopus)

    Abstract

    Purpose: To report a > 3-year experience with a modular, balloon- expandable endovascular graft used for aneurysm exclusion in the aorta and other arteries. Methods: The customized White-Yu Endovascular GAD Graft, a woven polyester prosthesis with an intrinsic Elgiloy wire graft attachment system along the body of the graft, is a flexible endograft design available in straight, tapered, and bifurcated versions that can be delivered transluminally through 18F to 24F sheaths. Results: Since July 1993, 93 patients have received the White-Yu endograft for treatment of 76 abdominal aortic, 3 thoracic aortic, 13 lilac, and 1 popliteal aneurysms. Of the 79 aortic procedures, 39 involved straight tube grafts, 20 were tapered aortoiliac models, and 20 were bifurcated devices. Success rates for tube grafts were 81% in the abdominal aorta and 100% for the thoracic aorta; 5 primary endoleaks (14%) and 2 conversions to surgery (5.6%) occurred with this graft type. Aortoiliac grafts were deployed successfully in 95% (19/20) of cases with 1 conversion (5%) due to thrombosis. Seventy-five percent of the bifurcated endograft procedures were successful, with 4 conversions (20%) for technical failures and 1 graft thrombosis. Four additional endografts were deployed to treat two primary and two secondary endoleaks in tube graft patients. Two access-related arterial injuries were treated surgically. There was one case of embolus to the distal femoral artery but no microembolization. Overall perioperative (30-day) mortality was 3.1%. Over a mean 18-month follow-up (range 2 to 39), no late graft thrombosis, stenosis, or graft migration has been seen on CT scans or X ray. Endoleak has not been detected in any aortoiliac or bifurcated graft. Aneurysm size has diminished consistently in successfully treated cases. Conclusions: The White-Yu endograft appears to offer a safe, efficacious, and minimally invasive means of excluding aneurysms from the circulation. Improvements in patient selection, surgical techniques, and equipment have reduced the incidence of endoleak and conversion to open repair over the course of the evaluation.

    Original languageEnglish
    Pages (from-to)124-136
    Number of pages13
    JournalJournal of Endovascular Surgery
    Volume4
    Issue number2
    DOIs
    Publication statusPublished - 1997

    Keywords

    • Abdominal aortic aneurysm
    • Endograft
    • Endovascular grafting
    • Iliac aneurysm
    • Popliteal aneurysm
    • Thoracic aortic aneurysm

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