RECENT DEVELOPMENTS IN T/EVAR 

The Journal of Cardiovascular Surgery 2014 February;55(1):85-92

Copyright © 2013 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.