Results of the ANCHOR prospective, multicenter registry of EndoAnchors for type Ia endoleaks and endograft migration in patients with challenging anatomy

Jordan, William D.; Mehta, Manish; Varnagy, David; Arko, Frank R.; Joye, James D.; Ouriel, Kenneth; Vries, Jean-Paul de; Vries, Jean Paul de; Eckstein, H.‐H.; Herwaarden, Joost van; Bove, P; Bohannon, W. Todd; Fioole, Bram; Setacci, Carlo; Resch, Timothy; Riambau, Vicente; Scheinert, Dierk; Schmidt, Andrej; Clair, Daniel G.; Moursi, Mohammed M.; Farber, Mark A.; Tessarek, Joerg; Torsello, Giovanni; Fillinger, Mark F.; Glickman, Marc H.; Henretta, John P.; Hodgson, Kim J.; Jim, Jeffrey; Katzen, Barry T.; Lipsitz, Evan C.; Cox, Mitchell; Naslund, Thomas C.; Ramaiah, Venkatesh G.; Schermerhorn, Marc L.; Schneider, Peter A.; Starnes, Benjamin W.; Donayre, Carlos E.; Zipfel, Burkhart; Malhotra, Nitin; Moore, William M.; Cheshire, Nick; Bicknell, Colin; Back, Martin R.; Muhs, Bart E.; Malas, Mahmoud B.; Hussain, Syed Jawad; Gupta, Navyash; Böckler, Dittmar; Verhoeven, Eric; Reijnen, Michel M.P.J.

doi:10.1016/j.jvs.2014.04.063

Cited by 124 publications

(118 citation statements)

References 23 publications

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“…This case confirms that endoanchors placement serves as a viable treatment option for type IA EL following EVAR failure. Aortic extender cuffs were used in conjunction with endoanchors when a significant length of the aortic neck was present between the proximal margin of the endograft and the lowest renal artery …”

Section: Discussionmentioning

confidence: 99%

“…Aortic extender cuffs were used in conjunction with endoanchors when a significant length of the aortic neck was present between the proximal margin of the endograft and the lowest renal artery. 1,20 Accurate preoperative planning is a critical issue in endovascular procedures, especially in redo endovascular aortic surgery. 21 Correct endoanchors deployment represents the key point of technical success in creating a new sealing.…”

Section: Discussionmentioning

confidence: 99%

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Endoanchors under 3D image fusion for a type IA endoleak after EVAR

Tinelli

Nigris

Minelli

et al. 2019

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoanchors under 3D image fusion for a type IA endoleak after EVAR

Tinelli

Nigris

Minelli

et al. 2019

Clinical Case Reports

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“…Providers can employ creative endovascular solutions for failed EVAR including cuff/limb extensions 18 , endostaples (HeliFx, Aptus Endosystems Inc., Sunnyvale, Calif) 19 , balloon-expandable stents 20 , and various methods of embolization 21, 22 . There are even descriptions of ‘off-label’ procedures such as parallel stent and fenestrated/branched techniques for salvage of failed EVAR 23, 24 .…”

Section: Introductionmentioning

confidence: 99%

Defining risk and identifying predictors of mortality for open conversion after endovascular aortic aneurysm repair

Scali

Beck

Chang

et al. 2016

Journal of Vascular Surgery

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Objective Risk of open conversion after endovascular aortic aneurysm repair(EVAR-c) is poorly defined. The purpose of this analysis was to determine outcomes of elective EVAR-c compared to elective primary open abdominal aortic aneurysm repair(PAR) in the Vascular Quality Initiative(VQI). Methods VQI patients undergoing elective EVAR-c and PAR(2002–2014) were reviewed. Candidate predictors of major adverse cardiac events(MACE) and/or 30-day mortality were entered into a multivariable model, and stepwise elimination was used to reduce the number of covariates to a best subset of predictors. To estimate the additive risk of EVAR-c for MACE or 30-day mortality over PAR, this variable was added along with the best subset of predictors into generalized estimating equations logistic regression models. Results 159 EVAR-c and 3,741 PAR patients were identified. EVAR-c patients were older (73.5±8.1 vs. 69.5±8.4 years;P<.0001), more likely to have diabetes(21% vs. 15%;P=.03) and prior history of lower extremity bypass(9% vs. 4%;P=.0006). EVAR-c was associated with a higher incidence of retroperitoneal aortic exposure(41%;N=64 vs. PAR, 26%, N=976;P<.0001), use of a bifurcated graft(65%;N=101 vs. PAR, 52%;N=1923;P=.001), greater blood loss (median, IQR: 2000mL[1010,3500] vs. PAR, 1200mL[750,2000];P<.0001) and longer procedure times (EVAR-c, 275±122min vs. PAR, 232±9min;P<.0001). However, PAR more frequently was completed with a suprarenal/mesenteric cross-clamp(74%, N=2749 vs. EVAR-c, 53%, N=83;P<.0001) and had a higher incidence of concomitant procedures(26%;N=972 vs. EVAR-c, 18%, N=28;P=.03). Non-risk adjusted 30-day mortality was higher after EVAR-c: EVAR-c, 8%(N=10) vs. PAR, 3%(N=105);P=.009. There was no difference in complication rates: EVAR-c, 33%(N=52) vs. PAR, 28%(N=1056);P=.3. Preoperative 30-day mortality predictors included age(OR 1.06/year, 95% C.I: 1.04–1.1;P<.0001), COPD (OR 2.4, 1.6–3.5;P<.0001), history of prior leg bypass (OR 2.3, 1.2–4.4;P=.01), suprarenal cross-clamp (OR 2.2, 1.2–4.1;P=.01), prior carotid revascularization (OR 2.2, 1.3–3.8;P=.0004), congestive heart failure (OR 1.8, .9–3.5;P=.08) and female gender (OR 1.6, 1.1–2.3;P=.02) (AUC=.75). When controlling for covariates, EVAR-c was not significantly associated with MACE (OR 1.2 95% CI 0.7–2.0;P=.4) or 30-day mortality (OR 2.0, .9–4.2;P=.08). Conclusions EVAR-c patients are typically older, have more comorbidities and experience greater blood loss and longer procedure times compared to PAR patients. However, postoperative morbidity and mortality are primarily driven by patient covariates and intraoperative factors, rather than the need for endograft explantation. Several preoperative variables were identified as predictors of 30-day mortality after elective EVAR-c and should be considered during the decision making process for remedial treatment of failed EVAR.

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“…Endoanchors have been demonstrated to favorably augment the proximal seal zone associated with endovascular aneurysm repair (EVAR) . Their use in the infrarenal abdominal aorta has been divided between repair of a proximal Type I endoleak and prophylactic placement in patients who are thought to be at increased risk for graft migration . Overall, procedural success has been reported to be 95% with endoanchors in the infrarenal abdominal aorta .…”

Section: Discussionmentioning

confidence: 99%

Endoanchor stenting for the repair of a Type I endoleak in the aortic arch following the endovascular repair of a Kommerrell's diverticulum

et al. 2016

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As more challenging aortic arch anatomy is being treated using aortic stent-grafts, there is an increased risk for proximal Type I endoleaks at the proximal seal zone or subsequent graft migration. We report a case of an endoanchor-assisted thoracic endovascular aneurysm repair of a patient with an aberrant right subclavian artery (ARSA) and aortic arch aneurysm who developed a proximal Type I endoleak in the aortic arch which was subsequently treated with endoanchors.

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Results of the ANCHOR prospective, multicenter registry of EndoAnchors for type Ia endoleaks and endograft migration in patients with challenging anatomy

Abstract: Use of EndoAnchors to treat existing and acute type Ia endoleaks and endograft migration was successful in most cases. Prophylactic use of EndoAnchors in patients with hostile aortic neck anatomy appears promising, but definitive conclusions must await longer term follow-up data.

Cited by 124 publications

References 23 publications

Endoanchors under 3D image fusion for a type IA endoleak after EVAR

Endoanchors under 3D image fusion for a type IA endoleak after EVAR

Defining risk and identifying predictors of mortality for open conversion after endovascular aortic aneurysm repair

Endoanchor stenting for the repair of a Type I endoleak in the aortic arch following the endovascular repair of a Kommerrell's diverticulum

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