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The Endurant Stent Graft System: 15-month follow-up report in patients with challenging abdominal aortic anatomies.
MedLine Citation:
PMID:  21611817     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study is to report a 15-month follow-up with the Endurant Stent Graft System in patients with challenging aortic anatomies. METHODS: At three German clinics, a consecutive series of 50 patients underwent endovascular abdominal aortic repair (EVAR) for challenging abdominal aortic aneurysm with the Endurant stent graft between November 2008 and May 2009. EVAR was elective in 48 cases and emergent in two. Patients had short (≤15 mm) aortic necks, severe suprarenal/infrarenal angulation, and/or small (<8 mm), calcified, severely angulated, or tortuous iliac or femoral access vessels. Additionally, a cohort of 40 patients without challenging anatomies were retrospectively analysed to clarify differences concerning technical success, mortality, and morbidity between these groups. RESULTS: The primary technical success rate was 92% (46/50). The 30-day mortality rate was 2% (1/50), the death due to multiorgan failure. Intraoperative angiograms revealed three type I endoleaks (2 proximal and 1 distal), and one of those was persisting at 30 days (30-day rate, 2%). Postoperative imaging discovered no further type I or type III endoleaks. The 30-day rate of the type II endoleak was 6% (3/50). There were two cases of graft limb occlusion, both requiring reintervention within 30 days. Follow-up was available in all of the 50 patients (100%) over a median of 15 months (1-25). During this time, seven patients died (overall mortality, 16%; 8/50), besides the above-described patient, all of them unrelated to the procedure. Compared to the 30-day results with the Endurant stent graft in non-challenging anatomies (no type I endoleak; no graft limb occlusion; all-cause mortality, 0%), procedure-related complications in challenging anatomies are increasing. CONCLUSION: Early and 15-month results with the Endurant stent graft in patients with challenging aortic anatomies are encouraging.
Authors:
Alexander Hyhlik-Dürr; Tim F Weber; Drossos Kotelis; Fabian Rengier; Johannes Gahlen; Stefanie Böck; Jürgen Köhler; Christoph-M Ratusinski; Dittmar Böckler
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-25
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie     Volume:  -     ISSN:  1435-2451     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Vascular and Endovascular Surgery, Ruprecht-Karls University, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany, alexander.duerr@med.uni-heidelberg.de.
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