PMID- 30706754
OWN - NLM
STAT- MEDLINE
DCOM- 20200608
LR  - 20200608
IS  - 1545-1550 (Electronic)
IS  - 1526-6028 (Linking)
VI  - 26
IP  - 2
DP  - 2019 Apr
TI  - Expanded Suitability of Ruptured Abdominal Aortic Aneurysms for Total 
      Endovascular Repair Using the Endurant Endograft and Heli-FX EndoAnchors.
PG  - 245-249
LID - 10.1177/1526602819828377 [doi]
AB  - PURPOSE: To assess if the suitability of endovascular aneurysm repair (EVAR) of 
      ruptured abdominal aortic aneurysms (RAAAs) can be expanded by combining the 
      Endurant stent-graft with the Heli-FX EndoAnchors. MATERIALS AND METHODS: 
      Contrast-enhanced computed tomography (CT) scans of 90 patients (mean age 73.2+/-9 
      years; 87 men) with RAAA admitted between January 2014 and January 2018 in 2 
      tertiary care centers were analyzed in a 3-dimensional workstation. Anatomical 
      features of the aneurysms according to the instructions for use (IFU) for the 
      Endurant endograft were evaluated and expansion of treatment with Heli-FX 
      EndoAnchors was assessed. RESULTS: Neck length <10 mm was present in 41 (45.6%) 
      patients; 5 had neck diameters outside the IFU and 45 (50.0%) had conical necks. 
      Thrombus and calcium were absent in 63 (70.0%) and 73 (81.1%), respectively. In 
      the study cohort, 44 (48.9%) patients met all the neck criteria, although overall 
      IFU compliance was found in only 35 (38.9%) patients due to iliac-related issues 
      in 21 patients. The adjunctive use of EndoAnchors in the entire study group would 
      enhance the therapeutic range to an additional 24 patients, 8 of whom would need 
      an associated iliac procedure. This represents an expansion of the total EVAR 
      approach from 48.9% to 75.6% of cases if some iliac issues are overcome and from 
      38.9% to 56.7% without correcting iliac deficiencies. CONCLUSION: The main reason 
      of being unfit for endovascular treatment in this series was neck length <10 mm. 
      Based on this analysis, nearly 40% of RAAA patients would have been candidates 
      for EVAR based on the IFU neck criteria for the Endurant stent-graft. This 
      suitability could be nearly doubled with the use of EndoAnchors and correction of 
      unsuitable iliac anatomy. The use of EndoAnchors has the potential to offer a 
      significant benefit in the endovascular treatment of RAAA patients.
FAU - Reyes Valdivia, Andres
AU  - Reyes Valdivia A
AUID- ORCID: 0000-0001-6282-1099
AD  - 1 Department of Vascular and Endovascular Surgery, Ramon y Cajal University 
      Hospital, Madrid, Spain.
FAU - Alvarez Marcos, Francisco
AU  - Alvarez Marcos F
AD  - 2 Department of Vascular and Endovascular Surgery, Complexo Hospitalario A 
      Coruna, Spain.
FAU - Duque Santos, Africa
AU  - Duque Santos A
AD  - 1 Department of Vascular and Endovascular Surgery, Ramon y Cajal University 
      Hospital, Madrid, Spain.
FAU - Ocana Guaita, Julia
AU  - Ocana Guaita J
AD  - 1 Department of Vascular and Endovascular Surgery, Ramon y Cajal University 
      Hospital, Madrid, Spain.
FAU - Gandarias Zuniga, Claudio
AU  - Gandarias Zuniga C
AD  - 1 Department of Vascular and Endovascular Surgery, Ramon y Cajal University 
      Hospital, Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20190201
PL  - United States
TA  - J Endovasc Ther
JT  - Journal of endovascular therapy : an official journal of the International 
      Society of Endovascular Specialists
JID - 100896915
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/*surgery
MH  - Aortic Rupture/diagnostic imaging/*surgery
MH  - *Blood Vessel Prosthesis
MH  - Blood Vessel Prosthesis Implantation/adverse effects/*instrumentation
MH  - Clinical Decision-Making
MH  - Endovascular Procedures/adverse effects/*instrumentation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - Prosthesis Design
MH  - Risk Factors
MH  - Spain
MH  - *Stents
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - EndoAnchors
OT  - abdominal aortic aneurysm
OT  - aneurysm neck
OT  - endograft
OT  - endovascular aneurysm repair
OT  - iliac artery
OT  - instructions for use
OT  - ruptured aneurysm
OT  - stent-graft
OT  - suitability
EDAT- 2019/02/02 06:00
MHDA- 2020/06/09 06:00
CRDT- 2019/02/02 06:00
PHST- 2019/02/02 06:00 [pubmed]
PHST- 2020/06/09 06:00 [medline]
PHST- 2019/02/02 06:00 [entrez]
AID - 10.1177/1526602819828377 [doi]
PST - ppublish
SO  - J Endovasc Ther. 2019 Apr;26(2):245-249. doi: 10.1177/1526602819828377. Epub 2019 
      Feb 1.