ORIGINAL ARTICLE  AORTIC DISEASE Free

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

DOI: 10.23736/S0392-9590.19.04023-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

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