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The Endurant Stent Graft System: 15-month follow-up report in patients with challenging abdominal aortic anatomies

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Abstract

Objective

The objective of this study is to report a 15-month follow-up with the Endurant Stent Graft System in patients with challenging aortic anatomies.

Methods

At three German clinics, a consecutive series of 50 patients underwent endovascular abdominal aortic repair (EVAR) for challenging abdominal aortic aneurysm with the Endurant stent graft between November 2008 and May 2009. EVAR was elective in 48 cases and emergent in two. Patients had short (≤15 mm) aortic necks, severe suprarenal/infrarenal angulation, and/or small (<8 mm), calcified, severely angulated, or tortuous iliac or femoral access vessels. Additionally, a cohort of 40 patients without challenging anatomies were retrospectively analysed to clarify differences concerning technical success, mortality, and morbidity between these groups.

Results

The primary technical success rate was 92% (46/50). The 30-day mortality rate was 2% (1/50), the death due to multiorgan failure. Intraoperative angiograms revealed three type I endoleaks (2 proximal and 1 distal), and one of those was persisting at 30 days (30-day rate, 2%). Postoperative imaging discovered no further type I or type III endoleaks. The 30-day rate of the type II endoleak was 6% (3/50). There were two cases of graft limb occlusion, both requiring reintervention within 30 days. Follow-up was available in all of the 50 patients (100%) over a median of 15 months (1–25). During this time, seven patients died (overall mortality, 16%; 8/50), besides the above-described patient, all of them unrelated to the procedure. Compared to the 30-day results with the Endurant stent graft in non-challenging anatomies (no type I endoleak; no graft limb occlusion; all-cause mortality, 0%), procedure-related complications in challenging anatomies are increasing.

Conclusion

Early and 15-month results with the Endurant stent graft in patients with challenging aortic anatomies are encouraging.

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Conflicts of interest

There was financial support from Medtronic for patients included in ENGAGE.

Author information

Authors and Affiliations

  1. Department of Vascular and Endovascular Surgery, Ruprecht-Karls University, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Alexander Hyhlik-Dürr, Drossos Kotelis, Stefanie Böck & Dittmar Böckler

  2. Department of Diagnostic and Interventional Radiology, Ruprecht-Karls University, Heidelberg, Germany

    Tim F. Weber

  3. Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

    Fabian Rengier

  4. Department of Vascular and Endovascular Surgery, Hospital Ludwigsburg, Ludwigsburg, Germany

    Johannes Gahlen

  5. Department of Vascular and Endovascular Surgery, Pius-Hospital, Oldenburg, Germany

    Jürgen Köhler & Christoph-M Ratusinski

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  1. Alexander Hyhlik-Dürr
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Correspondence to Alexander Hyhlik-Dürr.

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Hyhlik-Dürr, A., Weber, T.F., Kotelis, D. et al. The Endurant Stent Graft System: 15-month follow-up report in patients with challenging abdominal aortic anatomies. Langenbecks Arch Surg 396, 801–810 (2011). https://doi.org/10.1007/s00423-011-0806-7

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  • DOI: https://doi.org/10.1007/s00423-011-0806-7

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