Five-year results of the LEOPARD trial of commercially available endografts

Kwolek, Christopher J.; Ouriel, Kenneth; Stucky, Fred S.; Rao, Vikram K.; Pons, Peter J.; Wilson, Samuel E.; Kujath, Scott W.

doi:10.1016/j.jvs.2023.04.011

Journal of Vascular Surgery

2023

DOI: 10.1016/j.jvs.2023.04.011

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Five-year results of the LEOPARD trial of commercially available endografts

Christopher J. Kwolek¹,

Kenneth Ouriel²,

Fred S. Stucky³

et al.

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Cited by 5 publications

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“…Several studies have reported the long-term outcomes compared with other non-unibody devices. 5 , 6 , 7 , 8 , 9 The Strata material of the ePTFE graft has a potential risk of type IIIb endoleaks; thus, it was changed to Duraply in 2014. Although the cause of adverse outcomes with the AFX is still unknown, two studies reported that large (>60 or >65 mm) AAAs tended to cause sideways displacement, producing type IIIa endoleaks.…”

mentioning

confidence: 99%

Delayed migration due to shortening of the lower part of AFX endograft's main body in angled fusiform abdominal aortic aneurysm

Oda,

Takahashi,

Terao

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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mentioning

confidence: 99%

Delayed migration due to shortening of the lower part of AFX endograft's main body in angled fusiform abdominal aortic aneurysm

Oda,

Takahashi,

Terao

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Safety Evaluation of Unibody Endografts for Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Essam,

Hussein,

Ahmed

et al. 2024

Annals of Vascular Surgery

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The Enzen Trial: Analysis of EVAR Endoprosthesis Zenith and Endurant for Infrarenal Aortoiliac Aneurysms Regarding Outcomes, Endoleaks, and Reinterventions

de Athayde Soares,

Portela,

Amaro

et al. 2024

J Endovasc Ther

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Objective: The main objective of this paper is to analyze the outcomes regarding endoleaks, reinterventions, and death related to aneurysm complications in patients submitted to endovascular repair (EVAR) for abdominal aortoiliac aneurysm (AAA) using Endurant II (Medtronic) and Zenith Flex (Cook) endografts. Methods: This was a prospective, consecutive cohort study of patients with AAA who underwent EVAR between January 2019 and December 2022. Two groups of patients were evaluated: Group Endurant (patients submitted to EVAR with the use of Endurant II) and Group Zenith (patients submitted to EVAR with the use of Zenith Flex). Results: A total of 156 patients were evaluated. Group Zenith (67 patients, 42.9%) and Group Endurant (89 patients, 57.1%). The perioperative mortality was 5.1%, eight patients (six patients Group Zenith, and two patients Group Endurant, p=0.054). There were 28 patients (17.9%) submitted to urgent repair of the aneurysm (expansion or rupture), with no differences among the groups. There were 36 cases (23.1%) of later endoleak, with a higher incidence in Zenith group (23 patients, 34.3%) than Endurant group (13 patients, 14.6%, p=0.002), most of them Type II endoleak (21 patients, 13.4%). There were 12 cases of Type I endoleak, also with a higher prevalence in Zenith group (13.4%) than Endurant group (3.4%, p=0.002). Moreover, regarding limb graft occlusion (LGO), there were nine patients (5.8%), with a higher prevalence in Zenith group (9%) than Endurant group (3.4%, p=0.045). The overall survival in a Kaplan–Meier at 720 days was 82.3% in the Zenith group and 89.1% in the Endurant group, with no statistical significance among the groups (p=0.09). The freedom from reintervention rates in a Kaplan–Meier at 720 days was 82.8% in the Zenith group and 93.2% in the Endurant group (p=0.001). Conclusion: In this present study, Zenith endograft had higher rates of endoleaks, aneurysms related mortality, LGO and reinterventions than patients submitted to Endurant II endografts. The linear regression analysis showed that the presence of endoleaks, type of endograft device (Zenith graft) and limb graft occlusion were related to higher reintervention rates. Clinical Impact In this present study, Zenith endograft had higher rates of endoleaks, aneurysms related mortality, limb graft occlusions and reinterventions than patients submitted to Endurant II endografts. The main impact and the innovation that this article provides is an opportunity to evaluate and choose the best endograft suitable for the patient with AAA during EVAR.

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Five-year results of the LEOPARD trial of commercially available endografts

Cited by 5 publications

References 10 publications

Delayed migration due to shortening of the lower part of AFX endograft's main body in angled fusiform abdominal aortic aneurysm

Delayed migration due to shortening of the lower part of AFX endograft's main body in angled fusiform abdominal aortic aneurysm

Safety Evaluation of Unibody Endografts for Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

The Enzen Trial: Analysis of EVAR Endoprosthesis Zenith and Endurant for Infrarenal Aortoiliac Aneurysms Regarding Outcomes, Endoleaks, and Reinterventions

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