aneurysm (AAA) by a repositionable standard infrarenal endograft in patients with severe proximal neck bangle (!60). Methods: All consecutive patients treated by Gore Excluder C3 endograft for AAA, between 2011-2017 were enrolled in a prospective maintained database. Demographics, comorbidities, morphological detail of the aortic neck, intraoperative and follow-up data were retrospectively analysed. Patients with low-moderate (LMN) (<60) and with severe (SN) (!60) proximal neck bangle were compared. Primary endpoints were intraoperative endograft repositioning, proximal cuff positioning, renal artery lost and proximal type I endoleak (ELI). A composite endopoint was defined as the presence of at least one among intraoperative proximal cuff, renal artery lost and ELI. Secondary endpoints were mid-term ELI, AAA-shrinkage (!5mm), freedom from re-interventions (FFR) and Survival(S). Fisher exact test, Kaplan Meier and Log-Rank analysis were used for statistical evaluation. Results: In the study period a total of 147 patients (male 88%, mean age 72AE8 years, mean AAA-diameter 55AE8 mm) were enrolled. Mean neck angle was 41AE25 and patients with SN-angle were 45 (31%). Aortic neck was short (<15 mm) in 4.1% of cases, wide(>28mm) in 8.2% of cases and with severe(>50% of circumference) calcification and thrombus in 7.5% and 22% of cases respectively. SN-angle was associated with short and/or wide neck, severe neck calcification and/or thrombus in 5(3.4%) and 15(10.3%) patients, respectively. Endograft repositioning and intraoperative use of proximal cuff were performed in 41(28%) and in 5(3.4%) patients respectively. Intraoperative renal artery lost and ELI occurred in 2(1.4%) cases each one. Overall, early composite endpoint was reported in 6(4.1%) cases. In cases with SN-angle there were higher rate of endograft repositioning (47%vs20%,p¼.001), intraoperative proximal cuff (9%vs1%,p¼.03) and of composite endpoint (11%vs1%,p¼.01) than in patients with LMN-angle. No significant differences of intraoperative renal artery lost (4% vs0%,p¼.09) and ELI (2%vs0%,p¼.30) were reported between SN-and LMN-angle. The coexistence of SN-angle and one or more among short and/or wide-neck and severe neck calcification and/or thrombus does not negatively affect the results. The mean follow-up (FU) was 22AE18 months (range 6-77). AAA-shrinkage was observed in 89(61%) and late ELI were reported in 2 patients. Four (2.7%) patients had reinterventions and 6(4.1%) died during FU. No AAA-related mortality or rupture were reported. SN-angle was not associated with significant differences of AAA shrinkage (51%vs65%,p¼.14) and late ELI (0%vs2%,p¼1) if compared with LMN-angle. Overall FFR was 99%, 97% and 94%, at 12, 24 and 48-month, respectively. There were no differences between SN-angle (98% at 12, 24 and 48-month) and LMNangle (100%, 98% and 94% at 12, 24 and 48-month, respectively). Overall S was 99%, 98% and 91% at 12, 24 and 48-month, respectively. There were no differences between SN-angle (98% at 12, 24 and 48-month) and LMN-angle (100%,...
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