On March 17, 2008, the Food
and Drug Administration (FDA) issued a Public
Health Notification on the dangers of the AneuRx® Stent Graft System. This
notification urged healthcare professionals to continually watch patients
treated with endovascular grafts, and advised them of the risk of death
specifically associated with the use of the AneuRx® Stent Graft System to
prevent abdominal aortic aneurysm (AAA) rupture. This system is the only
one marketed with a substantial number of patients requiring long-term
clinical follow-up at five years.
The following are the FDA's recommendations to healthcare professionals and
patients:
"Clinicians should consider the information available in the product labels
and in the yearly clinical updates from Medtronic and other graft
manufacturers when selecting treatment options for patients with AAA and in
following previously treated patients. The clinical updates for three of the
currently marketed AAA endovascular grafts can be found at: http://www.endologix.com/health_clinical.php;
http://www.goremedical.com/excluder/annualupdate;
and http://www.medtronic.com/physician/aneurx/experience.html
Patients should be strongly encouraged to comply with the follow-up
recommendations in the product labeling.
Based on our findings, we recommend that the AneuRx® Stent Graft be used
only in patients who can be treated in accordance with the instructions for
use and who meet the appropriate risk-benefit profile. In determining the
risk-benefit profile for patients with AAA disease and the appropriate
treatment option, among the factors to consider are:
* Long-term AAA-related mortality, especially due to AAA rupture. The
information below suggests that the average risk of late AAA-related
mortality associated with AneuRx® exceeds that associated with open surgery.
* The experience of the institution or the physician. If open or
endovascular surgery is performed in institutions or by physicians with
little experience with open or endovascular AAA repair, the mortality rate
may be considerably higher than average with that procedure.
* Surgical risk factors for the individual patient. Patients who have
substantial surgical risk factors such as age and co-morbidities (e.g.,
cardiac, renal and pulmonary) may experience a higher than average mortality
rate for open resection of AAA. For a 70-year old patient, for example, the
rate could range from 2% with no risk factors to over 40% with multiple
co-morbidities.
* The patient's willingness to comply with the follow-up schedule for
the endovascular graft.".
The FDA issued two previous notifications regarding the AneuRx® which
informed caregivers and patients of numerous serious side effects, including
aneurysm ruptures. The risk of aneurysm-related deaths in patients with the
AneuRx® graft was much higher than patients undergoing open surgical repair.
The FDA worked with Medtronic Vascular, the manufacturer of AneuRx® for more
comprehensive data on patients who received the flexible model of the
AneuRx® Stent Graft.
Previous Public Health Notices stated that the late aneurysm-related death
rate due to the AneuRX® Stent Graft was about 0.4% per year. Additional
data provided to the FDA now indicates that the death rate increases three
years after implantation of the stent graft to 1.3% by year 4 and 1.5% by
year 5. These rates are considerably higher than the death rate for open
surgical repair, which averages about 0.18% per year, with a range of 0% to
0.3% per year.
If you or a family member has experienced any problems or death was caused
due to the AneuRX® Stent Graft, please fill out our Case Review Form to the
right of this page for a free consultation.
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