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International Angiology 2019 April;38(2):108-14

DOI: 10.23736/S0392-9590.19.04023-9


language: English

Four-year experience with the Endurant stent-graft for abdominal aortic and common iliac artery aneurysms in 50 consecutive Japanese patients

Toshiya NISHIBE 1 , Toru IWAHASHI 1, Kentaro KAMIYA 1, Satoshi TAKAHASHI 1, Koji KAWAGO 1, Keita MARUNO 1, Toshiki FUJIYOSHI 1, Akinari IWAHORI 1, Shun SUZUKI 1, Nobusato KOIZUMI 1, Jun KOIZUMI 2, Hitoshi OGINO 1

1 Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan; 2 Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan

BACKGROUND: To evaluate the 4-year results of the Endurant stent-graft in the treatment of abdominal aortic aneurysm (AAA) or common iliac artery aneurysm (CIAA).
METHODS: Between June 2012 and January 2014, 50 consecutive Japanese AAA and CIAA patients were treated with the Endurant stent-graft at Tokyo Medical University Hospital.
RESULTS: Estimated freedom from overall mortality, aneurysm-related mortality, and secondary interventions at 4 years was 61.7%, 97.9%, and 78.6%, respectively. At 4 years, the maximum sac diameter decreased by >5 mm in 24% of the patients, remained stable in 52%, and increased by >5 mm in 24%. The average aneurysm sac reduction was 0.4 to 1.3 mm within 5 years. Multivariate analyses detected female gender (HR: 7.40, P=0.021) and type IV endoleak (HR: 5.34, P=0.009) as a significant risk factor for secondary intervention.
CONCLUSIONS: Four-year clinical outcomes of the Endurant stent-graft remained positive in Japanese patients with AAA and CIAA, although 24% of the patients needed a secondary intervention. The aneurysm sac was stable in most of the patients, whereas the aneurysm sac reduction was small. These results suggest that careful imaging follow-up must be continued to determine the durability of the Endurant stent-graft in patients with small aneurysm sac reduction.

KEY WORDS: Aortic aneurysm, abdominal; Stents; Endovascular procedures

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