The Italian Multicentre Registry of Fenestrated Anaconda™ Endografts for Complex Abdominal Aortic Aneurysms Repair

Autor: Francesco Talarico, Raffaele Pulli, Carlo Stringari, D. Milite, Rodolfo Pini, Pierluigi Cappiello, Nicola Mangialardi, Franco Fadda Gian, Mauro Salvini, Gianluca Faggioli, Jacopo Giordano, Sonia Ronchey, Marco Solcia, Stefano Michelagnoli, Bruno Palmieri, Paolo Frigatti, Fabio Pilon, Mauro Gargiulo, Silvio Licata, Carlo Pratesi, Michelangelo Ferri, Reinhold Perkmann, Emiliano Chisci
Přispěvatelé: Pini R., Giordano J., Ferri M., Palmieri B., Solcia M., Michelagnoli S., Chisci E., Fadda Gian F., Cappiello P., Talarico F., Licata S., Frigatti P., Ronchey S., Mangialardi N., Pratesi C., Salvini M., Milite D., Pilon F., Perkmann R., Stringari C., Pulli R., Faggioli G., Gargiulo M.
Rok vydání: 2019
Předmět:
Zdroj: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 60(2)
ISSN: 1532-2165
Popis: Objective The aim was to describe the outcomes of the Anaconda™ Fenestrated endograft Italian Registry for complex aortic aneurysms (AAAs), unsuitable for standard endovascular aneurysm repair (EVAR). Methods Between 2012 and 2018 patients with a proximal neck unsuitable for standard EVAR, treated with the fenestrated Anaconda™ endograft, were prospectively enrolled in a dedicated database. Endpoints were peri-operative technical success (TS) and evaluation of type Ia/b or 3 endoleaks (T1/3 EL), target visceral vessel (TVV) occlusion, re-interventions, and AAA related mortality at 30 days, six months, and later follow up. Results One hundred twenty seven patients (74 ± 7 years, American Society Anesthesiology (ASA) II/III/IV: 12/85/30) were included in the study in 49 Italian Vascular Surgery Units (83 juxta/para-renal AAA, 13 type IV thoraco-abdominal AAA, 16 T1aEL post EVAR, and 15 short neck AAA). Configurations with one, two, three, and four fenestrations were used in 5, 56, 39, and 27 cases, respectively, for a total of 342 visceral vessels. One hundred and eight (85%) bifurcated and 19 (15%) tube endografts were implanted. In 35% (44/127) of cases the endograft was repositioned during the procedure, and 37% (128/342) of TVV were cannulated from brachial access. TS was 87% (111/127): five T1EL, six T3EL (between fenestration and vessel stent), and six loss of visceral vessels (one patient with a Type Ia EL had also a TVV loss) occurred. Thirty day mortality was 4% (5/127). Two of the five T1EL resolved spontaneously at 30 days. The overall median follow up was 21 ± 16 months; one T1EL (5%) occurred at six months and one T3EL (4%) at the three year follow up. Another two (3%) TVV occlusions occurred at six months and five (3%) at three years. The re-intervention rate at the 30 days, six months, and three year follow up was 5%, 7%, and 18 ± 5%, respectively. Conclusion The fenestrated Anaconda™ endograft is effective in the treatment of complex AAA. Some structure properties, such as the re-positionability and the possibility of cannulation from above, are specific characteristics helpful for the treatment of some complex anatomies.
Databáze: OpenAIRE
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