Improvement of patient eligibility with the use of new generation endografts for the treatment of abdominal aortic aneurysms. A comparison study among currently used endografts and literature review

Expert Rev Med Devices. 2017 Mar;14(3):245-250. doi: 10.1080/17434440.2017.1281738. Epub 2017 Jan 19.

Abstract

Background: Newer generation devices have attempted to accommodate a wider range of aortoiliac anatomies offering endovascular aneurysm repair (EVAR) to more patients with abdominal aortic aneurysms (AAAs). We aim to examine the anatomic suitability for the ultra-low profile Ovation endograft in our AAA patients and to compare them with other contemporary devices.

Methods: 158 consecutive AAA patients treated with EVAR or open surgical repair (OSR) were tested for EVAR eligibility according to the most commonly used endografts' instructions for use.

Results: 106 patients underwent EVAR and 52 OSR. EVAR eligibility was higher for the Ovation system (72%) compared to the rest of the devices (Incraft: 63%, Nellix: 60%, Endurant-II: 59%, Excluder: 55%, Zenith-Flex: 36%, Aorfix: 35%, P-value<0.001). Non-suitable proximal neck anatomy followed by access vessel inadequacy were the primary reasons for ineligibility.

Conclusion: New generation aortic endografts with innovative proximal sealing mechanisms and ultra-low profile delivery systems are increasing patient eligibility for EVAR.

Keywords: Endovascular aneurysm repair; aortic neck angulation; endograft sizing; endoleak; seal zone.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Aortic Aneurysm, Abdominal / pathology
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Male