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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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ORIGINAL ARTICLES TOWARDS AN ENTIRELY ENDOVASCULAR AORTIC WORLD
The Journal of Cardiovascular Surgery 2016 Ottobre;57(5):716-29
The use of EndoAnchors to rescue complicated TEVAR procedures
Sarah B. ONGSTAD 1, Daniel F. MILLER 1, Jean M. PANNETON 1, 2 ✉
1 Vascular Surgery Department, Eastern Virginia Medical School, Norfolk, VA, USA; 2 Division of Vascular Surgery, Sentara Heart Hospital, Norfolk, VA, USA
BACKGROUND: The aim of this study was to assess the applicability and outcomes of EndoAnchor use in the endovascular repair of thoracic and thoracoabdominal aortic aneurysms.
METHODS: A retrospective review was performed of all thoracic endovascular aortic repairs (TEVARs) performed with the use of EndoAnchors between December 2012 and January 2016. Primary study endpoints included freedom from migration, freedom from aortic- related intervention, and freedom from post-operative type I or type III endoleak.
RESULTS: During this study period, a total of 54 patients underwent TEVAR for thoracic or thoracoabdominal aneurysm with the use of EndoAnchors at our institution. Twenty-seven cases were performed as the index operation. Twenty-seven cases were considered redo operations. EndoAnchors were deployed for therapeutic and prophylactic indications. Mean follow-up was 9.6±8.8 months. EndoAnchors were used for therapeutic indications in 31.5% of patients and for prophylactic indications in 68.5%. The technical success of EndoAnchor deployment was 99.8%. The overall initial technical success of the operation was 98.1%. There were no instances of graft migration. The overall endoleak rate was 5.4% with prophylactic EndoAnchor use and 11.8% with therapeutic use. Aortic-related reintervention was required in 13.5% of patients who received prophylactic EndoAnchor placement and 23.5% of patients who received therapeutic EndoAnchor placement. Only one reintervention was performed for EndoAnchor failure. A p value of <0.05 was considered significant.
CONCLUSIONS: EndoAnchors can be safely utilized in TEVAR with high rates of technical success. These results demonstrate the potential to enhance thoracic endograft efficacy and durability with the use of therapeutic and prophylactic EndoAnchors. Long-term data is needed to further define the use of this technology in the thoracic aorta.