Background: The aim of this study was to evaluate the early results of the CE-marked standardized device combination consisting of Endurant and the Radiant chimney graft (En-ChEVAR) for the treatment of juxtarenal aortic aneurysms.
Methods: We analyzed multicentric non-industry sponsored case series evaluating the EnChEVAR technique for patients treated between December 2022 and February 2024. Clinical, perioperative procedure-related and radiological data were collected. The primary outcome measure was the freedom of a type Ia gutter-related endoleak at postoperative computed tomography angiography (CTA). Secondary outcome measures included early type Ia endoleak-related reinterventions, target vessel complications including dissection or loss of target vessel, major adverse events, and mortality. Continuous variables were presented as median (interquartile range [IQR]) and categorical variables as count and percentage.
Results: Ten patients were included in the present study. Eight (80%) were males, in nine cases a single chimney was implanted, and the other one was a double chimney graft placement. The treated aneurysms had an infrarenal neck length of 3.4 (1.2) mm. The rate of main body oversizing was 30%. The new neck length after chimney graft placement was 18 (3) mm. The median procedural time was 130 (17) mm, contrast medium use was 109 (26) mL, radiation time was 45 (12) min. The technical success was 100%. No type Ia endoleak was detected at the postoperative CTA. There were no target vessel issues. No major adverse events or death were observed.
Conclusions: First reported cohort of patients treated with EnChEVAR demonstrated reproducible clinical and procedural outcomes within the 3 vascular centers with total exclusion of the aneurysms, patent renal arteries, and no evidence of gutter-related type IA endoleak. Further evidence with larger sample size of treated patients and longer follow-up are needed.
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http://dx.doi.org/10.23736/S0021-9509.24.13056-X | DOI Listing |
Med Eng Phys
December 2024
Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Introduction: Abdominal aortic aneurysms present a significant clinical challenge, particularly when located near the renal arteries. In cases of infra-renal abdominal aortic aneurysms, the main stent graft may occlude the renal arteries, disrupting blood supply. To prevent this, two 'chimney' stent grafts can be implanted to maintain renal artery perfusion.
View Article and Find Full Text PDFVasc Endovascular Surg
October 2024
Department of Cardiovascular Surgery, Mayo Clinic Health System, Eau Claire, WI, USA.
EJVES Vasc Forum
June 2024
Department of Vascular Surgery, Lausanne University Hospital, Lausanne, Switzerland.
Introduction: Endovascular aneurysm sealing (EVAS) appeared to be an innovative alternative to conventional endovascular abdominal aortic aneurysm repair. However, high rates of midterm failure of EVAS led to withdrawal of the device from the market. The study aim was to report midterm outcomes of patients treated with EVAS alone or associated with chimneys (Ch-EVAS) and the management of their complications.
View Article and Find Full Text PDFSAGE Open Med Case Rep
August 2024
Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Coexistent aneurysmal involvement of common iliac artery is frequently seen in patients with infrarenal abdominal aortic aneurysm. Bilateral iliac branch devices are an option to preserve bilateral internal iliac arteries in order to decrease the risk of buttock claudication. In Asian population, however, the aortoiliac lengths are commonly not adequate for bilateral iliac branch endoprosthesis.
View Article and Find Full Text PDFJ Clin Med
August 2024
Vascular and Endovascular Surgery Unit, San Giovanni-Addolorata Hospital, 00184 Rome, Italy.
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