The Anaconda™ AAA Stent Graft System: 2-Year Clinical and Technical Results of a Multicentre Clinical Evaluation

Rödel, Steffan; Geelkerken, R.H.; Prescott, R. J.; Florek, H.-J.; Kasprzak, Piotr; Brunkwall, Jan

doi:10.1016/j.ejvs.2009.08.007

Cited by 50 publications

(38 citation statements)

References 20 publications

(11 reference statements)

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“…However, the outcomes with newer generation devices with different device profiles and attachment mechanisms when placed outside the IFU are unknown for EVAR. [13][14][15][16][17][18][19] In our present series, we used the Endurant stent graft in patients with normal and hostile aortoiliac anatomy. This new-generation device obtained the Conformité Européene mark in July 2008 and is commercially available in all European countries.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 During the last years, new grafts have been proposed to expand the indications for EVAR to patients with a hostile anatomy of the proximal aortic neck. [13][14][15] First-generation stent grafts relied on a variety of proximal attachments, including radial force, suprarenal stents, barbs, and columnar strength. The need to treat high-risk patients with a hostile aortic neck anatomy extended the use of the stent grafts even in off-label (OL) situations, but the applications outside of anatomically specific instructions for use (IFU) seem to affect the long-term results of these first-generation devices.…”

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confidence: 99%

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Evaluation of the Endurant stent graft under instructions for use vs off-label conditions for endovascular aortic aneurysm repair

Torsello

Troisi

Donas

et al. 2011

Journal of Vascular Surgery

107

108

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In patients with both normal and complex anatomy of the proximal aortic neck, the Endurant stent graft obtained acceptable results, with no difference in survival, morbidity, or reinterventions. However, there was a greater risk of type I endoleak when OL indications were applied. Longer term follow-up is required to evaluate the effectiveness of this endograft in preventing late aneurysm-related complications.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of the Endurant stent graft under instructions for use vs off-label conditions for endovascular aortic aneurysm repair

Torsello

Troisi

Donas

et al. 2011

Journal of Vascular Surgery

107

108

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“…The Anaconda AAA stent-graft system and implantation procedure have been extensively described elsewhere. 6 , 8 , 17 In short, the Anaconda stent-graft is a repositionable 3-piece endovascular graft for infrarenal fixation and consists of a woven polyester graft supported by independent nitinol ring stents that each comprise a single strand of wound nitinol wire, that is, a wire bundle ( Figure 1 ). The proximal part of the main body consists of a self-expanding dual ring, which assumes the shape of a “saddle” when oversized and constrained against the aortic wall.…”

Section: Methodsmentioning

confidence: 99%

“…The Anaconda AAA stent-graft (Vascutek, a Terumo company, Inchinnan, Scotland) is a self-expanding infrarenally fixating device with a proximal dual ring design that assumes a saddle shape with peaks and valleys when oversized and deployed in the aortic neck ( Figure 1 ). The initial design of Lauterjung in 1996 has evolved to a device with favorable midterm results, 6 – 8 even in severely angulated anatomy. 9 , 10 From clinical observations, it appears that over time the rings expand and the saddle shape flattens.…”

Section: Introductionmentioning

confidence: 99%

Evolution of the Proximal Sealing Rings of the Anaconda Stent-Graft After Endovascular Aneurysm Repair

et al. 2018

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Purpose: To provide insight into the evolution of the saddle-shaped proximal sealing rings of the Anaconda stent-graft after endovascular aneurysm repair (EVAR). Methods: Eighteen abdominal aortic aneurysm patients were consecutively enrolled in a single-center, prospective, observational cohort study (LSPEAS; Trialregister.nl identifier NTR4276). The patients were treated electively using an Anaconda stent-graft with a mean 31% oversizing (range 17–47). According to protocol, participants were to be followed for 2 years, during which 5 noncontrast electrocardiogram-gated computed tomography scans would be conducted. Three patients were eliminated within 30 days (1 withdrew, 1 died, and a third was converted before stent-graft deployment), leaving 15 patients (mean age 72.8±3.7 years; 14 men) for this analysis. Evolution in size and shape (symmetry) of both proximal infrarenal sealing rings were assessed from discharge to 24 months using dedicated postprocessing algorithms. Results: At 24 months, the mean diameters of the first and second ring stents had increased significantly (first ring: 2.2±1.0 mm, p<0.001; second ring: 2.7±1.1 mm, p<0.001). At 6 months, the first and second rings had expanded to a mean 96.6%±2.1% and 94.8%±2.7%, respectively, of their nominal diameter, after which the rings expanded slowly; ring diameters stabilized to near nominal size (first ring, 98.3%±1.1%; second ring, 97.2%±1.4%) at 24 months irrespective of initial oversizing. No type I or III endoleaks or aneurysm-, device-, or procedure-related adverse events were noted in follow-up. The difference in the diametric distances between the peaks and valleys of the saddle-shaped rings was marked at discharge but became smaller after 24 months for both rings (first ring: median 2.0 vs 1.2 mm, p=0.191; second ring: median 2.8 vs 0.8 mm; p=0.013). Conclusion: Irrespective of initial oversizing, the Anaconda proximal sealing rings radially expanded to near nominal size within 6 months after EVAR. Initial oval-shaped rings conformed symmetrically and became nearly circular through 24 months. These findings should be taken into account in planning and follow-up.

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“…Since this was a new technique, we decided to employ a repositionable ASG to ensure LoRA patency at the end of the procedure. 3 IVUS has been proposed as an imaging diagnostic technique that can provide useful information during endovascular stent graft repair. 4,5 Unlike traditional arteriography, IVUS provides the real-time visualisation of the vascular findings.…”

mentioning

confidence: 99%

Endovascular Aneurysm Repair Using Anaconda Repositionable Aortic Stent Graft Assisted Exclusively by Intravascular Ultrasound Imaging

Barbera

Rosa

Valentino

et al. 2019

Vascular and Endovascular Review

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Arteriography with contrast medium (CM) injection is normally employed to visualise the lowest renal artery during endovascular aneurysm repair (EVAR). Intravascular ultrasound (IVUS) has been proposed as an alternative, real-time imaging diagnostic technique to arteriography. In this study, we evaluated the feasibility of EVAR using Anaconda repositionable aortic stent graft (Vascutek) assisted by IVUS (Volcano Visions, Philips) during intraluminal navigation without CM. From January 2016 to December 2017, 25 patients with infrarenal abdominal aortic aneurysms, identified through anatomical inclusion criteria, underwent EVAR. All of the patients had an arteriogram at the end of the EVAR procedure to confirm aortic stent graft patency and to exclude type 1 endoleaks. The primary objective was the technical and clinical success of this CM-free aortic stent graft delivery procedure. At the end of the period, 150 target vessels were evaluated. IVUS versus angio-CT sensitivity and specificity rate were 97.3% and 100%, respectively. The primary technical success was obtained in 88% of the cases. Three patients (12%) needed CM injection to complete the procedure and there were no cases of type 1 endoleak. Primary clinical success was 100%. During follow-up at a mean of 20 months, none of the patients died or had complications. We conclude that a full EVAR procedure is feasible using only IVUS navigation and repositionable aortic stent graft without CM injection in anatomically selected cases.

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The Anaconda™ AAA Stent Graft System: 2-Year Clinical and Technical Results of a Multicentre Clinical Evaluation

Abstract: The design features of the second-generation Anaconda AAA Stent Graft System are effective in the treatment of AAAs on mid-term evaluation.

Cited by 50 publications

References 20 publications

Evaluation of the Endurant stent graft under instructions for use vs off-label conditions for endovascular aortic aneurysm repair

Evaluation of the Endurant stent graft under instructions for use vs off-label conditions for endovascular aortic aneurysm repair

Evolution of the Proximal Sealing Rings of the Anaconda Stent-Graft After Endovascular Aneurysm Repair

Endovascular Aneurysm Repair Using Anaconda Repositionable Aortic Stent Graft Assisted Exclusively by Intravascular Ultrasound Imaging

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