Progressive Device Failure at Long Term Follow Up of the Nellix EndoVascular Aneurysm Sealing (EVAS) System

Type 1A endoleak detachable coil embolization after endovascular aneurysm sealing: Case report

“…Despite this assumption, when compared to standard EVAR, EVAS was associated with a higher endoleak occurrence and device failure up 43.5% at long-term [ 2 ]. Actually, all patients treated with Nellix system (Endologix Inc.) are at risk of AAA growth and stent migration independently forms instruction for use adherence [ 6 ].…”

“…Singh et al reported a large experience in EVAS failure management with a clear indication to surgical explanation in fit patients. The same authors argued that NINA could not represent an option due to the resilience from the manufacture to provide graft removed from the market [ 2 ]. However, it can be argued that all the worldwide implanted Nellix system (Endologix Inc.) would require a reintervention for device failure, and most of them will be unfit for conventional surgery, as reported in our case.…”

“…Proximal embolization has been associated with high failure incidence and inefficiency regarding Nellix system (Endologix Inc.) migration [ 2 ]. In this single case experience the 6-months CT angiography showed complete AAA exclusion and Nellix system (Endologix Inc.) stability.…”

“…Endovascular aneurysm sealing (EVAS), with the Nellix system (Endologix Inc., Irvine, CA, US) has been introduced with the aim to reduce EVAR perioperative complications, especially endoleaks by filling endobags in order to seal the aneurysm [ 1 ]. Despite encouraging short outcomes, mid- and longer-term results have shown a significant higher incidence of EVAS related complications, and in 2019 the Nellix system (Endologix Inc.) has been withdrawn from the marked [ 2 ]. Herein we report a case of type 1A endoleak after EVAS managed with detachable coils embolization.…”

Innovative solutions for endovascular aneurysm sealing—delayed Nellix type 1a endoleak

“…The absence of endobag polymer filling in a VINA-approach logically render it more prone to gutter-leaks, persistence of NT1AE and, hence has a higher likelihood of needing adjunctive coil-embolization to achieve thrombosis. Despite their shortcomings, both NINA and VINA can be useful inclusions within the Vascular specialist's armamentarium as we are likely J o u r n a l P r e -p r o o f to see more NT1AE secondary to progressive device failure and disappointing long-term followup outcomes 16 .…”