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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 VASCULAR SECTION
The Journal of Cardiovascular Surgery 2016 Dicembre;57(6):846-52
Initial single-site experience with the Ovation abdominal stent-graft system in patients with challenging aortoiliac anatomy
Luigi IRACE 1, Stefano VENOSI 1, Roberto GATTUSO 1, Antonella LAURITO 1, Valentina POMPA 2, Giacomo PASINATI 2, Luciano BRESADOLA 2 ✉
1 Department of Vascular Surgery, Policlinico Umberto I, “Sapienza” University, Rome, Italy; 2 Department of Interventional Radiology, Policlinico Umberto I, “Sapienza” University, Rome, Italy
BACKGROUND: Aim of the study was to evaluate the initial results of endovascular aneurysm repair with the Ovation abdominal stent-graft system in patients with challenging aortoiliac anatomy.
METHODS: The Ovation stent-graft is an ultra-low profile, modular endovascular graft characterized by a 14F OD delivery system, active suprarenal fixation, and polymer-filled proximal rings that allow sealing in short (≥7 mm) proximal necks. Between November 2010 and January 2012, 14 patients with abdominal aortic aneurysms (AAA) (male: 100%, mean age: 76 years, mean AAA diameter: 54 mm) and challenging aortoiliac anatomy were treated with the Ovation endograft at a single centre. Mean patient follow-up was 5 months.
RESULTS: All cases were performed under local or epidural anesthesia. No operative deaths or major complications were noted. A type I endoleak was detected on final angiogram in one case, which was successfully treated with additional ballooning and Palmaz stenting of the hooking landing zone. One patient died at 2 months due to myocardial infarction unrelated to the device or procedure. AAA-related mortality was 0%. No AAA rupture, AAA enlargement, type I or III endoleak, stent migration, access site complication, or conversion to open surgery was reported during follow-up. A type II endoleak was successfully treated with a right lumbar artery embolization at 4 months. Occlusion of an iliac axis was successfully managed with local fibrinolysis and implantation of a covered stent in the external iliac artery.
CONCLUSIONS: Initial outcomes of this single-center experience suggest that the Ovation abdominal stent-graft system is a promising treatment in AAA patients with challenging aortoiliac anatomy.