Abstract
Objectives:We used an expanded polytetrafluoroethylene (ePTFE) graft for abdominal aortic aneurysm (AAA) surgery hoping to reduce the incidence of postoperative inflammatory reactions compared to that observed when using a sealed graft. Patients and methods: From May 1998 to September 2006, 138 AAA patients, including 21 emergency patients, with an average age of 70.9 years underwent replacement surgery with an ePTFE graft. Results: There were 5 fatalities (4 operative deaths and 1 hospital death) and 1 severe morbidity (sigmoid colon necrosis) among the emergency patients. Homologous blood transfusions were needed in 18.8% of the scheduled cases. On average, the peak body temperature was 37.7℃, and the white blood cell count on the first postoperative (PO) day was 9400/mm3. The serum C-reactive protein (CRP) level was elevated from 7.1 mg/dl on the first PO day to 14.4 mg/dl on the fourth PO day. A gradual decrease in temperature, white blood cell count, and serum CRP level was then observed, the values becoming 36.7℃, 6300/mm3, and 1.8 mg/dl, respectively, by the 12th PO day. No biphasic-inflammatory pattern, like that observed with sealed grafts, was recorded. Late angiographic findings (average of 1180 days after surgery) showed a patency of 97.6% and 87.9% in the external iliac artery and the internal iliac artery, respectively. New aneurysmal changes in the residual internal iliac arteries were found in 2 patients, and perigraft seromas were noted in 10 patients. Conclusion: The use of an ePTFE graft in AAA surgery is advantageous in terms of no postoperative abnormal inflammatory reaction, no loss of hemostatic control, and good patency rate.
