Keywords
Endovascular Procedure
Stents
How to Cite
Abstract
Background: Endovascular abdominal aortic aneurysm repair (EVAR) devices are associated with a higher rate of complications at 5-year follow-up. At least 30% of patients with EVAR devices require some type of reintervention (whether endovascular or open) at 10-year follow-up. These complications include endoleak, abdominal aortic aneurysms rupture, graft migration, occlusion or infection. The objective of this paper was to determine the rates of failure for each type of EVAR stent-graft used in our local population. Also, this paper is the first step to create a Colombian and Latin American transnational EVAR device registry. Material and Methods: Single-center retrospective observational cohort study. Thirty-four patients with abdominal aortic aneurysms (AAA) treated with EVAR were included from 2011 through 2017. Data were collected from the patients’ electronic medical records. Results: The stent-graft Endologicx Ba (Endologix, Irvine, CA, United States), Excluder (W.L. Gore, Newark, DE, United States), Zenith (Cook Medical, Bloomington, IN, United States), and Nellix endovascular aneurysm sealing system (EVAS) (Endologix, Santa Rosa, CA, United States) were not associated with any endoleaks or any type of complications after the EVAR procedure. The Aorfix (Lombard, Didcot, United Kingdom), and Endurant (Medtronic, Minneapolis, MN, United States) stent-grafts had rates of type II endoleak (in 1 and 2 patients) of 2.9% and 5.8%, respectively that closed spontaneously. No stent-graft developed type I, III or IV endoleaks or any endovascular or open reinterventions were needed. Conclusions: This study shows that the different types of stent-graft used for to treat AAA with EVAR can be used in a safe and feasible way with good postoperative clinical outcomes in the Latin American population.
References
Kent F, Ambler G, Bosanquet D, Twine C, on behalf of BSET (British Society for Endovascular Therapy). The Safety of Device Registries for Endovascular Abdominal Aortic Aneurysm Repair: Systematic Review and Meta-regression. Eur J Vasc Endovasc Surg. 2018; 55:177e183.
Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg. 1991; 5(06):491–499.
Volodos NL, Karpovich IP, Troyan VI, Kalashnikova YuV, Shekhanin VE, Ternyuk NE, et al. Clinical experience of the use of self-fixing synthetic prostheses for remote endoprosthetics of the thoracic and the abdominal aorta and iliac arteries through the femoral artery and as intraoperative endoprosthesis for aorta reconstruction. Vasa Suppl. 1991; 33:93–95.
Duffy JM, Rolph R, Waltham M. Stent graft types for endovascular repair of abdominal aortic aneurysms. Cochrane Database Syst Rev. 2013; 3:CD008447.
Duffy JM, Rolph R, Waltham M. Stent graft types for endovascular repair of abdominal aortic aneurysms. Cochrane Database Syst Rev 2015; 2015(9):CD008447.
Zarins CK, White RA, Moll FL, Crabtree T, Bloch DA, Hodgson KJ, et al. The AneuRx stent graft: four-year results and worldwide experience 2000. J Vasc Surg. 2001; 33:135e45.
Verzini F, Romano L, Parlani G, Simonte G, Loschi D, Isernia G, et al. RS10. Fourteen-year outcomes of abdominal aortic endovascular repair with the Zenith stent graft. J Vasc Surg. 2016; 63:143Se4S.
White S, Stavropoulos W. Management of Endoleaks following Endovascular Aneurysm Repair. Semin Intervent Radiol. 2009; 26(1):33–38.
Carino D, Sarac T, Ziganshin B, Elefteriades J. Abdominal Aortic Aneurysm: Evolving Controversies and Uncertainties. Int J Angiol. 2018; 27(2):58–80.
Thomas SM, Gaines PA, Beard JD; Vascular Surgical Society of Great Britain and Ireland; British Society of Interventional Radiology. Short-term (30-day) outcome of endovascular treatment of abdominal aortic aneurism: results from the prospective Registry of Endovascular Treatment of Abdominal Aortic Aneurism (RETA). Eur J Vasc Endovasc Surg. 2001; 21(1):57-64.
Harris PL, Vallabhaneni SR, Desgranges P, Becquemin JP, van Marrewijk C, Laheij RJ. Incidence and risk factors of late rupture, conversion, and death after endovascular repair of infrarenal aortic aneurysms: the EUROSTAR experience. European Collaborators on Stent/graft techniques for aortic aneurysm repair. J Vasc Surg. 2000; 32(04):739–749.
Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG; EVAR trial participants.Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet. 2004; 364(9437):843–848.
Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med. 2004;351(16):1607–1618.
Lederle FA, Freischlag JA, Kyriakides TC, Padberg FT Jr, Matsumura JS, Kohler TR, et al. Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA. 2009;302(14):1535–1542.
Stavropoulos SW, Clark TW, Carpenter JP, Fairman RM, Litt H, Velazquez OC, et al. Use of CT angiography to classify endoleaks after endovascular repair of abdominal aortic aneurysms. J Vasc Interv Radiol. 2005; 16:663–667.
Karthikesalingam A, Cobb R, Khoury A, Choke E, Sayers R, Holt P, et al. The morphological applicability of a novel endovascular aneurysm sealing (EVAS) system (Nellix) in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2013; 46:440e5.