Midterm outcomes of AFX2 endografts used in combination with aortic cuffs

Late Type III Endoleak after Loss of Component Overlap after EVAR with AFX2 Device: A Case Report

“…Despite improvements made to the AFX2 device to address endoleak issues, controversy persists regarding its safety [7][8][9]. Previous studies have reported the occurrence of delayed T3aE, especially with early AFX models [6,8].…”

“…Despite improvements made to the AFX2 device to address endoleak issues, controversy persists regarding its safety [7][8][9]. Previous studies have reported the occurrence of delayed T3aE, especially with early AFX models [6,8]. T3aE is a serious concern, as it re-exposes the AAA sac to direct arterial pressure, potentially leading to sac enlargement, rupture, and death.…”

Combined AFX2 with thoracic stent graft: A different endovascular approach of an abdominal aorta aneurysm

“…It was considered ideal for many reasons, including reverse tapered or bulging necks, just like our patient’s case. 5 Due to the large neck of the AAA and the possible type of intraoperative Ia endoleak, 6 – 9 the AFX2 endograft was combined with a thoracic stent, which sealed the neck, without a final angiographic image of the endoleak.…”

“… 8 , 11 – 13 Hoshina et al 8 reported a series of 175 patients repaired with AFX2 endograft in combination with aortic cuffs, recording low rates of types IIIa and IIIb endoleaks and higher rates of sideways displacement and migration in the midterm (3.1%), which could cause future type IIIa endoleaks. 8 On the other hand, Ankura is a suprarenal nitinol stent graft that fixes inside the aorta at the level of the renal arteries, where proportions of endoleaks and repeat interventions were 11.4% and 7.6%, respectively, which is consistent with literature data on elective EVARs. 11 According to early- and mid-term complication rates, these rates are comparable to those of other stent grafts with suprarenal fixation.…”

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

“…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.…”