ENDOVASCULAR ANEURYSM REPAIR: CURRENT STATUS ON DEVICE SPECIFICATIONS AND OUTCOMES
DOI:
https://doi.org/10.48750/acv.135Keywords:
Abdominal aortic aneurysm, Endovascular aneurysm repair, endograftAbstract
Introduction: Since its first introduction in 1991, endovascular aneurysm repair (EVAR) became the preferred modality for abdominal aortic aneurysms (AAA) repair. Several devices have been launched over the years addressing progressively more complex anatomies. The aim of this review is to provide an update on current endografts and compare their results.
Methods: MEDLINE databases were searched for endografts features and respective outcomes.
Results: Currently, a significant variety of grafts is approved for clinical use, targeting different anatomic properties. There are presently six CE and FDA approved devices: Zenith®, AFX®, C3 EXCLUDER®, Endurant® II, Ovation® and Aorfix™; while six more have only the CE mark: Anaconda™, E-vita ABDOMINAL XT®, E-tegra®, Incraft®, TREOVANCE® and Altura™. Also, there are four fenestrated and branched endografts available for treating thoracoabdominal aneurysms: Zenith® Fenestrated, Fenestrated Anaconda™, Zenith® p-Branch® and Zenith® t-Branch®. The Endurant II and Treovance stent grafts can accommodate neck lengths ≥10 mm; Aorfix and Anaconda are more liberal regarding neck angulation, extending of infrarenal neck angulation up to 90º. Finally, Zenith, C3 Excluder, Ovation and Incraft stent grafts can be used with distal fixation length ≥10 mm.
Conclusion: New-generation endografts perform better than the older ones, especially in challenging anatomies. Mid-term outcomes between contemporary stent-grafts seem to be similar for most of the outcomes. However, no randomized controlled trials exist comparing different contemporary stent grafts, making conclusions difficult to accomplish. Longterm follow-up reviews are required to assertively take assumptions about different stent grafts performance.
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18. Sirignano P, Mansour W, Pranteda C, Siani A, Accrocca F, d’Adamo
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19. Perdikides T, Georgiadis GS, Avgerinos ED, Fotis T, Verikokos
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abdominal aortic aneurysms with angulated necks and/
or tortuous iliac arteries: midterm results. J Endovasc Ther.
2009;16(5):567-76.
20. Rodel SG, Geelkerken RH, Prescott RJ, Florek HJ, Kasprzak P,
Brunkwall J, et al. The Anaconda AAA stent graft system: 2-year
clinical and technical results of a multicentre clinical evaluation.
Eur J Vasc Endovasc Surg. 2009;38(6):732-40.
21. Rodel SG, Zeebregts CJ, Huisman AB, Geelkerken RH, Multicenter
Angulated Neck Study with the Anaconda study p. Results
of the Anaconda endovascular graft in abdominal aortic
aneurysm with a severe angulated infrarenal neck. J Vasc Surg.
2014;59(6):1495-501, 501 e1.
22. Scheinert D, Pratesi C, Chiesa R, Coppi G, Brunkwall JS, Klarenbeek
G, et al. First-in-human study of the INCRAFT endograft in
patients with infrarenal abdominal aortic aneurysms in the INNOVATION
trial. J Vasc Surg. 2013;57(4):906-14.
23. Sugimoto M, Torsello GF, Torsello GB, Austermann M, Stachmann
A, Bisdas T. Postmarket Clinical Experience with the INCRAFT
AAA Stent Graft System for Challenging Access Routes. Ann
Vasc Surg. 2017;40:120-7.
24. Chiesa R, Riambau V, Coppi G, Zipfel B, Llagostera S, Marone EM, et
al. The Bolton Treovance abdominal stent-graft: European clinical
trial design. J Cardiovasc Surg (Torino). 2012;53(5):595-604.
25. Rylski B, Czerny M, Sudkamp M, Russe M, Siep M, Beyersdorf
F. Fenestrated and Branched Aortic Grafts. Dtsch Arztebl Int.
2015;112(48):816-22.
26. Graves HL, Jackson BM. The Current State of Fenestrated and
Branched Devices for Abdominal Aortic Aneurysm Repair. Semin
Intervent Radiol. 2015;32(3):304-10.
27. Oderich GS, Correa MP, Mendes BC. Technical aspects of repair of
juxtarenal abdominal aortic aneurysms using the Zenith fenestrated
endovascular stent graft. J Vasc Surg. 2014;59(5):1456-61.
28. Bungay PM, Burfitt N, Sritharan K, Muir L, Khan SL, De Nunzio MC,
et al. Initial experience with a new fenestrated stent graft. J Vasc
Surg. 2011;54(6):1832-8.
29. Bakoyiannis CN, Economopoulos KP, Georgopoulos S, Klonaris C,
Shialarou M, Kafeza M, et al. Fenestrated and branched endografts
for the treatment of thoracoabdominal aortic aneurysms: a
systematic review. J Endovasc Ther. 2010;17(2):201-9.
30. Shahverdyan R, Gray D, Gawenda M, Brunkwall J. Technical feasibility
of endovascular aortoiliac aneurysm repair combining
Anaconda fenestrated and Zenith iliac side-branched stent
grafts. J Vasc Surg. 2015;61(5):1324-8.
31. Rolls AE, Jenkins M, Bicknell CD, Riga CV, Cheshire NJ, Burfitt N, et
al. Experience with a novel custom-made fenestrated stent graft
in the repair of juxtarenal and type IV thoracoabdominal aneurysms.
J Vasc Surg. 2014;59(3):615-22.
32. Dijkstra ML, Tielliu IF, Meerwaldt R, Pierie M, van Brussel
J, Schurink GW, et al. Dutch experience with the fenestrated
Anaconda endograft for short-neck infrarenal and juxtarenal
abdominal aortic aneurysm repair. J Vasc Surg. 2014;60(2):301-7.
33. Tim Resch M, PhD. Global Experience With the Zenith p-Branch
Device. Endovascular Today. 2015.
34. Mark Farber M. Current State and Future of Fenestrated Technology.
Endovascular Today. 2013.
35. Kitagawa A, Greenberg RK, Eagleton MJ, Mastracci TM. Zenith
p-branch standard fenestrated endovascular graft for juxtarenal
abdominal aortic aneurysms. J Vasc Surg. 2013;58(2):291-300.
36. Nordon IM, Thompson MM, Loftus IM. Are concerns about EVAR
durability relevant with modern devices? J Cardiovasc Surg (Torino).
2013;54(2):181-9.
37. Bisdas T, Weiss K, Eisenack M, Austermann M, Torsello G, Donas
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Published
2018-06-07
How to Cite
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Cordeiro F, Oliveira-Pinto J, Mansilha A. ENDOVASCULAR ANEURYSM REPAIR: CURRENT STATUS ON DEVICE SPECIFICATIONS AND OUTCOMES. Angiol Cir Vasc [Internet]. 2018 Jun. 7 [cited 2024 Apr. 19];14(2):121-32. Available from: https://acvjournal.com/index.php/acv/article/view/135
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