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The Journal of Cardiovascular Surgery 2016 August;57(4):485-90


lingua: Inglese

Single-centre experience with the Gore C3 Excluder stent-graft in 200 consecutive patients

Athanasios KATSARGYRIS, Hozan MUFTY, Roxana WOJS, Genevieve UTECH, Eric L. VERHOEVEN

Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany


BACKGROUND: To present short and mid-term outcomes from 200 consecutive patients treated with the new C3 Gore Excluder stent-graft in a single institution.
METHODS: All patients treated with the C3 Excluder stent-graft between August 2010 and October 2015 in our institution were included in a prospective database. Treatment indication, intraoperative stent-graft repositioning, technical success, operative mortality and morbidity, survival, endoleak, complications, reintervention during follow-up were analyzed.
RESULTS: A total of 200 patients (175 male, mean age 72.4±9.2 years) were enrolled, including 180 for aortic aneurysms. Mean aortic aneurysm diameter was 57±10.8 mm, and mean neck length 27.9±11.6 mm. One hundred and eighty four cases were elective and 16 acute. Technical success was achieved in 196 (98%) patients. In three patients a small type I endoleak persisted at completion angiography, but disappeared at the first postoperative CTA. One patient presenting with a ruptured aortic plaque after branched repair of a type III thoracoabdominal aneurysm died intraoperatively. Stent-graft repositioning was performed in 89 (44.5%) patients with a total of 127 repositioning events. Adverse events related to repositioning were noticed in three cases, but repaired by endovascular means. Thirty-day mortality was zero for elective cases and 2/16 (12.5%) for acute cases accounting for an overall mortality of 1%. Mean follow-up time was 17.8±16.6 months (range 0-62 months). Ten patients died during follow-up, one from an aneurysm-related cause (aortoenteric fistula). Cumulative survival was 97.2±1.4% at 1 year, and 89.6±3.4% at 3 years. No migration, type I/ III endoleak, nor limb occlusion was detected during follow-up. Estimated freedom from reintervention was 92.4±2.2% at 1 year, and 89.9±2.8% at 3 years.
CONCLUSIONS: In this patient cohort, the C3 Excluder stent-graft provided excellent early and mid-term outcomes with null 30-day mortality in elective cases, and null type I endoleak and limb occlusion during follow-up. The option for repositioning was frequently utilized. Excessive repositioning resulted in three adverse events, all three successfully treated by endovascular means.

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