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Midterm Single-Center Results of Endovascular Aneurysm Repair With Additional EndoAnchors.
- Source :
-
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2019 Feb; Vol. 26 (1), pp. 90-100. Date of Electronic Publication: 2018 Dec 04. - Publication Year :
- 2019
-
Abstract
- Purpose: To review midterm clinical outcomes of EndoAnchor placement during or after endovascular aneurysm repair (EVAR) or chimney EVAR (ch-EVAR).<br />Materials and Methods: A retrospective analysis was conducted of 51 consecutive patients [median age 75 years; 38 men] who underwent EVAR/ch-EVAR with EndoAnchor placement between June 2010 and December 2016 to prevent seal failures (31, 61%) or to treat type Ia endoleak and/or migration (20, 39%). Median aortic neck diameter was 27.7 mm and median neck length was 9.0 mm. Thirty-three (65%) had a conical neck; 48 (94%) had at least 1 hostile neck characteristic. Thirty-two (63%) patients had severe comorbidities (ASA score ⩾III). Eight patients had a single ch-EVAR procedure. Baseline patient characteristics, anatomic variables, procedure details, early and late complications, reinterventions, and aneurysm-related and all-cause mortality rates were recorded. Follow-up imaging was performed with computed tomography angiography (CTA) or duplex ultrasonography.<br />Results: Median procedure time was 100 minutes; a median of 6 EndoAnchors were implanted. There were 10 (10%) residual type Ia endoleaks at the end of the procedure; 9 had resolved by the first postoperative CTA. One residual and 2 new type Ia endoleaks were identified at the first postoperative imaging. Median follow-up for the entire cohort was 24.0 months, during which 3 new type Ia endoleaks were identified. Five of the 6 type Ia endoleaks were treated, 1 resolved spontaneously. There was 1 endograft limb occlusion without clinical consequences, 1 chimney graft occlusion without possibilities for a reintervention, 1 rupture after type IV endoleak (a Nellix device was successfully deployed within the main device), and 1 complete graft explantation for infection. There was no new-onset hemodialysis. Kaplan-Meier estimates of freedom from type Ia endoleak, proximal neck-related reinterventions, and aneurysm-related mortality at 2 years were 87.3%, 92.2%, and 94.0%, respectively.<br />Conclusion: EndoAnchors are helpful in the endovascular treatment of unfavorable proximal aortic necks, with fair midterm results.
- Subjects :
- Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal diagnostic imaging
Aortic Aneurysm, Abdominal mortality
Blood Vessel Prosthesis Implantation adverse effects
Blood Vessel Prosthesis Implantation mortality
Endoleak etiology
Endovascular Procedures adverse effects
Endovascular Procedures mortality
Female
Humans
Male
Middle Aged
Netherlands
Progression-Free Survival
Retrospective Studies
Risk Factors
Time Factors
Aortic Aneurysm, Abdominal surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation instrumentation
Endovascular Procedures instrumentation
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1545-1550
- Volume :
- 26
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Publication Type :
- Academic Journal
- Accession number :
- 30514134
- Full Text :
- https://doi.org/10.1177/1526602818816099