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

Abstract

Background The introduction of endovascular aortic repair has revolutionised the treatment of abdominal aortic aneurysms, replacing open surgical repair for the majority of elective cases due to its optimal morbidity and mortality. Several endovascular aortic repair stent grafts exist commercially, one of which is the Fenestrated Anaconda™ by Terumo Aortic which benefits from a very innovative design, unique custom-made approach and highly favourable results. Aims The main scope of this narrative review is to provide a comprehensive overview of endovascular aortic repair clinical outcomes using the Fenestrated Anaconda™ stent-graft and comparing these with its market competitor, Zenith. This review will also examine the evidence in the literature on the Anaconda™'s custom-made approach. Methods A comprehensive literature was conducted on several search engines including PubMed, Google Scholar, Ovid, Scopus and Embase to collate the evidence in the literature on clinical outcomes achieved with the Fenestrated Anaconda™ and Zenith including, but not limited to, survival, technical success, target vessel patency, endoleak, reintervention and aneurysm sac regression. Results The Fenestrated Anaconda™ is associated with excellent results, including highly favourable survival, technical and clinical success and target vessel patency rates, very low need for reintervention or conversion, and minimal incidence of complications such as endoleak and endograft migration. The Fenestrated Anaconda™ also drives significant sac regression and aortic remodelling. In addition, its unique custom-made approach enables it to treat highly complex aortic anatomy as well as to ‘rescue’ failed competitor grafts. Conclusion The Fenestrated Anaconda™ has proven that it is a very safe, highly applicable and extremely effective device used for complex aortic and/or iliac pathology based on its novel design and outstanding track record of clinical outcomes.

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

“…58 All the above evidence, in addition to our results as well as the results of recent studies, unequivocally suggest that the Fenestrated Anaconda™ is the primary EVAR device choice for achieving long-term patient longevity and favourable late clinical outcomes, particularly survival, TVP, endograft migration and reintervention. [59][60][61] However, studies directly comparing endografts under similar clinical circumstances are encouraged.…”

Impact of patient demographics and intraoperative characteristics on abdominal aortic aneurysm sac following endovascular repair

“…However, based on the findings in this review, it can be suggested that the Anaconda may achieve the most optimal sac regression relative to market competitors. To lend further evidence in support of the Anaconda, a recent scoping review by Jubouri et al 62 compared Anaconda with Zenith, highlighting a wide variety of clinical outcomes achieved using both devices. The authors clearly concluded that the Anaconda can be considered the superior EVAR 2022 Cross-sectional international analysis 5058 Anaconda A sac regression of 0-30% was observed in 4772 (94.3%) patients over the first four years post-EVAR.…”