Abstract
Purpose
To report the early results of a multicenter registry of endovascular aneurysm repair (EVAR) using the Endurant stent-graft.
Methods
Patients having elective treatment of infrarenal abdominal aortic aneurysm (AAA) with the Endurant stent-graft at 3 Canadian centers were enrolled in a prospective registry between September 2008 and January 2010. In the 16-month period, 111 patients (90 men; mean age 75 years, range 53–93) were registered. Thirty-seven (33.3%) patients had challenging anatomy: short proximal aortic necks (n = 17), large diameter (>28 mm) aortic necks (n = 4), angulated (>60°) necks (n=3), and small (<15 mm) external iliac arteries (n=21). Outcomes evaluated included survival, endoleak, aneurysm expansion >5 mm, secondary intervention, stent-graft migration, and graft thrombosis.
Results
The overall technical success rate was 100%. Nineteen (17.1%) patients experienced perioperative complications. After a mean follow-up of 6 months (range 0.1–16), mortality in the series was 4.5%: 1 perioperative death (multisystem organ failure) and 4 (3.6%) late deaths (3 cardiac, 1 cancer). Clinical and imaging follow-up past the perioperative period were available in 107 (96.4%) and 99 (89.2%) patients, respectively. Among the latter, 9 (9.1%) had a type II endoleak on the first scan; 4 resolved spontaneously. Three (3.0%) patients developed graft limb thrombosis in follow-up; one required an intervention. There was no graft migration, aneurysm expansion, secondary intervention for endoleak, aneurysm rupture, or conversion.
Conclusion
Early results from this prospective multicenter registry indicate that the Endurant stent-graft is a safe option for elective EVAR in selected AAA patients. Longer follow-up is required to determine the durability of these outcomes.
Keywords
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