Early results with the custom-made Fenestrated Anaconda aortic cuff in the treatment of complex abdominal aortic aneurysm

Abstract

Treatment with this specific custom-made fenestrated aortic cuff is feasible after complicated previous (endovascular) aortic repair or in complex AAAs. The complexity of certain AAA cases is underlined in this study, and the Fenestrated Anaconda aortic cuff is a valid option in selected cases in which few treatment options are left.

Endovascular solutions for abdominal aortic aneurysms: A comparative review of clinical outcomes with custom-made endografts

“…A different study by the same group reported 99 ± 1% and 88 ± 6% TVP at 1 and 2 years, respectively. 37 Similarly, Dijkstra et al 16 found that primary patency in their study was 96% at 1-month post-EVAR while TVP was 98.1%. Importantly, three studies [12][13][14] reported 100% TVP with another six studies 16,21,[27][28][29]31 achieving a TVP rate of ≥ 98%.…”

“…A 2018 study by the same group identified 14 out of 27 patients with stable or decreased aneurysm sac diameters. 37 To further ascertain the Fenestrated Anaconda™'s outstanding aortic remodelling results, Freyrie et al 17 observed AAA shrinkage of > 5 mm in 130 out of 177 patients (73.4%), with only seven patients (4%) showing AAA sac enlargement. Furthermore, Stehr et al 39 reported a substantial reduction of the median aneurysm diameter from 56.7 to 49.0 mm after 6 months ( P = 0.05).…”

“…Moreover, of the 271 cases studied by Tigkiropoulos et al,20 4.7% had Type 1 EL, with Type 2 EL observed in only 6.6% of patients out of which all resolved spontaneously by 12 months follow-up post-EVAR. Another study by de Niet et al37 consisting of 29 patients saw no cases of Type 1 EL but only two of Type 3 EL, both of which were treated successfully during follow-up. To further highlight the Fenestrated Anaconda™'s effectiveness, a 2018 study of 126 patients with a median follow-up of 2 years found freedom from Type 1a at 1 and 4 years to be 95 ± 2% and 93 ± 3%, respectively.…”

Patient longevity and survival with custom-made endovascular solutions: The Fenestrated AnacondaTM approach

“…37 Importantly, 7 Fenestrated Anaconda™ studies identified within the literature achieved TVP of >97%, a summary of which can be found in Table 6. 20,23,28,37,[38][39][40] On the other hand, the aforementioned Oderich et al 31 reported 95.2 ± 1.9% and 82.7 ± 4.1% primary TVP at 1 and 5 years, respectively, using Zenith. While Sveinsonn et al 41 achieved 96.4% and 94.0% primary TVP with Zenith after 1 and 5 years, respectively.…”

Novel Technique for the Treatment of Type Ia Endoleak After Endovascular Abdominal Aortic Aneurysm Repair

“…To address this issue several options have been proposed, including treatment with fenestrated cuffs sealing in the preexisting main body, which may however lead to type III endoleaks or complete relining of the previous endograft with use of a bifurcated distal component featuring an inner limb. 14 The latter option minimizes the overlap of the bifurcated to the fenestrated component as well as to the contralateral iliac limb also potentially leading to type III endoleaks. One advantage of this branched design is that distal landing is achieved on the ipsilateral side with the tapered main body and on the contralateral side with a bridging stent-graft to the respective limb through the additional branch.…”