Preliminary results of adjunctive use of endoanchors in the treatment of short neck and pararenal abdominal aortic aneurysms

Galiñanes, Edgar Luis; Hernández, Eduardo; Krajcer, Zvonimir

doi:10.1002/ccd.26351

Cited by 20 publications

(15 citation statements)

References 16 publications

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“…Several investigators have evaluated the EndoAnchors technique both in the prevention and treatment of endograft migration and type Ia endoleaks to achieve an effective proximal sealing. 14–19 The ANCHOR prospective trial included 319 patients at 43 sites in the United States and Europe; 242 (75.9%) had EndoAnchors implanted at the time of the first operation (primary implant), whereas 77 patients were treated for proximal aortic neck complications after EVAR (secondary implant). The authors reported overall procedural success in 279 patients (87.5%), in particular in 217 of 240 (89.7%) in the primary implant arm and in 62 of 77 (80.5%) in the secondary arm.…”

Section: Discussionmentioning

confidence: 99%

The use of EndoAnchors in endovascular repair of abdominal aortic aneurysms with challenging proximal neck: Single-centre experience

Giudice

Borghese

Sbenaglia

et al. 2019

JRSM Cardiovascular Disease

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Objectives The aim of this study was to present a single-centre experience with EndoAnchors in patients who underwent endovascular repair for abdominal aortic aneurysms with challenging proximal neck, both in the prevention and treatment of endograft migration and type Ia endoleaks. Methods We retrospectively analysed 17 consecutive patients treated with EndoAnchors between June 2015 and May 2018 at our institution. EndoAnchors were applied during the initial endovascular aneurysm repair procedure (primary implant) to prevent proximal neck complications in difficult anatomies (nine patients), and in the follow-up after aneurysm exclusion (secondary implant) to correct type Ia endoleak and/or stent-graft migration (eight patients). Results Mean time for anchors implant was 23 min (range 12–41), with a mean of 5 EndoAnchors deployed per patient. Six patients in the secondary implant group required a proximal cuff due to stent-graft migration ≥10 mm. Technical success was achieved in all cases, with no complications related to deployment of the anchors. At a median follow-up of 13 months (range 4–39, interquartile range 9–20), there were no aneurysm-related deaths or aneurysm ruptures, and all patients were free from reinterventions. CT-scan surveillance showed no evidence of type Ia endoleak, anchors dislodgement or stent-graft migration, with a mean reduction of aneurysm diameter of 0.4 mm (range 0–19); there was no sac growth or aortic neck enlargement in any case. Conclusions EndoAnchors can be safely used in the prevention and treatment of type Ia endoleaks in patients with challenging aortic necks, with good results in terms of sac exclusion and diameter reduction in the mid-term follow-up.

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Section: Discussionmentioning

confidence: 99%

The use of EndoAnchors in endovascular repair of abdominal aortic aneurysms with challenging proximal neck: Single-centre experience

Giudice

Borghese

Sbenaglia

et al. 2019

JRSM Cardiovascular Disease

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“…Studies have identified a direct association between short proximal aortic necks and EVAR failure, i.e., presence of endoleaks. 6 Special techniques are therefore needed to solve these complex cases.…”

Section: Discussionmentioning

confidence: 99%

Tratamento de endoleak tipo 1A mediante embolização com molas: relato de caso

et al. 2019

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Resumo No endoleak tipo 1A, a endoprótese não sela completamente o colo do aneurisma proximal, e o fluxo arterial está presente entre a parede do colo aórtico e o material do implante. Este é um relato de um caso no qual foi utilizada embolização com molas, associado a uma revisão de literatura (PubMed, LILACS e SciELO). Foram pesquisados artigos publicados nos últimos 5 anos com os descritores “endoleak 1A”, “coil embolization” e “treatment”, combinados de formas aleatórias, sendo encontrados 25 artigos. O tipo 1A ocorre em 1,1% dos pacientes após 30 dias do implante. O tratamento consiste em aumentar a vedação do implante proximal, principalmente com o uso de stents e balões para alargar a zona de aterragem ou aumentar a força radial do implante. Alguns trabalhos sugerem técnicas de embolização com cianoacrilato, cola de fibrina e uso de Onyx, mostrando taxas de sucesso superiores a 97%. Contudo, a correção de endoleaks tipo 1A mediante embolização com molas é pouco descrita.

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“…9,10,13,14 Moreover, EndoAnchors in combination with chimney EVAR (ch-EVAR) procedures have been described only sporadically. 15,16 Currently, midand long-term outcomes after EndoAnchor use is limited to the results from the ANCHOR multicenter registry. [9][10][11]13 Therefore, this study assesses the 2-year clinical outcomes of patients treated with EndoAnchors after EVAR and ch-EVAR in a single high-volume center.…”

Section: Introductionmentioning

confidence: 99%

Midterm Single-Center Results of Endovascular Aneurysm Repair With Additional EndoAnchors

et al. 2018

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To review midterm clinical outcomes of EndoAnchor placement during or after endovascular aneurysm repair (EVAR) or chimney EVAR (ch-EVAR). Materials and Methods: A retrospective analysis was conducted of 51 consecutive patients [median age 75 years; 38 men] who underwent EVAR/ch-EVAR with EndoAnchor placement between June 2010 and December 2016 to prevent seal failures (31, 61%) or to treat type Ia endoleak and/or migration (20, 39%). Median aortic neck diameter was 27.7 mm and median neck length was 9.0 mm. Thirty-three (65%) had a conical neck; 48 (94%) had at least 1 hostile neck characteristic. Thirty-two (63%) patients had severe comorbidities (ASA score ⩾III). Eight patients had a single ch-EVAR procedure. Baseline patient characteristics, anatomic variables, procedure details, early and late complications, reinterventions, and aneurysm-related and all-cause mortality rates were recorded. Follow-up imaging was performed with computed tomography angiography (CTA) or duplex ultrasonography. Results: Median procedure time was 100 minutes; a median of 6 EndoAnchors were implanted. There were 10 (10%) residual type Ia endoleaks at the end of the procedure; 9 had resolved by the first postoperative CTA. One residual and 2 new type Ia endoleaks were identified at the first postoperative imaging. Median follow-up for the entire cohort was 24.0 months, during which 3 new type Ia endoleaks were identified. Five of the 6 type Ia endoleaks were treated, 1 resolved spontaneously. There was 1 endograft limb occlusion without clinical consequences, 1 chimney graft occlusion without possibilities for a reintervention, 1 rupture after type IV endoleak (a Nellix device was successfully deployed within the main device), and 1 complete graft explantation for infection. There was no new-onset hemodialysis. Kaplan-Meier estimates of freedom from type Ia endoleak, proximal neck-related reinterventions, and aneurysm-related mortality at 2 years were 87.3%, 92.2%, and 94.0%, respectively. Conclusion: EndoAnchors are helpful in the endovascular treatment of unfavorable proximal aortic necks, with fair midterm results.

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Preliminary results of adjunctive use of endoanchors in the treatment of short neck and pararenal abdominal aortic aneurysms

Abstract: EndoAnchors are an applicable adjunct to EVAR as treatment for short infrarenal neck and pararenal AAAs. Further investigations are needed to determine the durability of this novel application.

Cited by 20 publications

References 16 publications

The use of EndoAnchors in endovascular repair of abdominal aortic aneurysms with challenging proximal neck: Single-centre experience

The use of EndoAnchors in endovascular repair of abdominal aortic aneurysms with challenging proximal neck: Single-centre experience

Tratamento de endoleak tipo 1A mediante embolização com molas: relato de caso

Midterm Single-Center Results of Endovascular Aneurysm Repair With Additional EndoAnchors

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