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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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RECENT DEVELOPMENTS IN T/EVAR
The Journal of Cardiovascular Surgery 2014 February;55(1):85-92
Two-year-results of Endurant stent-graft in challenging aortic neck morphologies versus standard anatomies
Setacci F. 1, Sirignano P. 1, de Donato G. 1, Galzerano G. 1, Messina G. 2, Guerrini S. 3, Mazzei M. A. 3, Setacci C. 1 ✉
1 Vascular and Endovascular Surgery Unit Department of Medical Surgical and Neurosciences University of Siena, Siena, Italy;
2 Area of Public Health, Department of Molecular and Developmental Medicine University of Siena, Siena, Italy;
3 Section of Radiological Sciences Department of Medical, Surgical and Neurosciences University of Siena, Siena, Italy
Aim: The aim of this paper was to evaluate the influence of a challenging neck on mid-term results using the Endurant I stent-graft system in high risk patients.
Methods: A retrospective study was conducted on a prospectively compiled database of 72 elective patients with challenging neck treated with the Endurant I system (Endurant Stent Graft, Medtronic AVE, Santa Rosa, CA, USA). These patients were compared to a control group (65 patients) without significant neck problems. The endpoints were mid-term 2-years technical, clinical success and the event free survival of all treated patients.
Results: Mean age was 76.12 years; 76.6% of patients were males. Risk factors and preoperative variables did not differ significantly between the two groups. Only 4 (5.5%) patients of the study group vs. 2 (3.1%) in the control group developed type I endoleak during the follow-up. Three (4.1%) study group patients developed type III endoleak vs. 2 (3.1%) in the control group. All these patients required an adjunct procedure of relining with a new endograft. No type II endoleaks requiring adjunctive endovascular procedures were detected in our series. The 2-year event free survival rate did not differ statistically between the two groups (P=0.425).
Conclusion: Treatment with the Endurant stent-graft is technically feasible and safe, yielding satisfactory results even in challenging anatomies. Mid-term results are promising and challenge current opinion concerning the negative influence of challenging neck anatomy on EVAR especially after a longer follow-up.