Endurant Stent-Graft: A 2-Year, Single-Center Experience With a New Commercially Available Device for the Treatment of Abdominal Aortic Aneurysms

Abstract

The Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair (EVAR), even in patients with hostile aortoiliac anatomy. However, perioperative and midterm complications occur, which could be explained by the expansion of indications for EVAR. Further studies are needed to evaluate the long-term results.

The Endurant Stent Graft System: 15-month follow-up report in patients with challenging abdominal aortic anatomies

“…In our selected group of patients, a higher mortality rate was expected but was also not found in the 2-year single-centre analysis with the Endurant stent graft in a similar cohort by Troisi (2.6%) [32]. For these patients, the surgeon's preference was for EVAR rather than open repair because of the high comorbidities.…”

“…In our present series, only one type I endoleak (2%) occurred (primary endoleak) in a patient with a reversed tapered aortic neck (8 mm) combined with a relevant neck thrombus. These constellations were to be held responsible to affect the rate of type I endoleaks more than angulation of the aortic neck [32]. Due to differences in the device designs (Table 4) and the varying anatomical conditions in these trials, the data can be compared only with great circumspection.…”

Early results of the Endurant endograft system in patients with friendly and hostile infrarenal abdominal aortic aneurysm anatomy

“…1,2 Over the last few years, technological advancements and further clinical research have mainly focused on the development and introduction of new generation stent graft devices, such as those with enhanced flexibility to overcome challenging anatomies. [3][4][5][6][7][8][9][10][11] Hostile infrarenal aortic anatomy is a major cause of failure of EVAR [12][13][14][15][16][17] and for that reason a significant proportion of patients with adverse aneurysm morphology still benefit from conventional open repair. Unfavorable anatomical conditions, such as severe infrarenal aortic neck angulation (Ͼ60°) and dilated aortic neck, are associated with a high incidence of proximal type I endoleak 17 and stent graft migration, 17,18 respectively.…”

“…Other anatomical limitations, such as a very short proximal neck and severe angulation of the iliac arteries have also been described. Cumulative clinical experience and technical advances with the evolution of newer more flexible stent graft devices 3,5,[7][8][9]19,20 have all been working together to circumvent adverse aneurysm morphologies, with a view to expanding the applications of endovascular treatments for aortic aneurysms. Recently, late generation stent grafts, like the Endurant (Medtronic Cardiovascular, Santa Rosa, Calif) device, have been developed to overcome complex aortic morphologies and improve EVAR outcomes.…”

Chimney Technique in the Endovascular Repair of Juxtarenal Abdominal Aortic Aneurysm

“…The follow-up ranged from 2 to 24 weeks and they showed a 30-day mortality of 0 % and a 100 % patency rate with no endoleaks. In 2010, Troisi et al published their experience with 13 patients treated with chimneys in the renal arteries due to short necks [ 13 ] . In their follow-up they describe one type 3 and one type 1 endoleak.…”