TY - JOUR
T1 - Midterm results of the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair
AU - Blankensteijn, Louise L.
AU - Dijkstra, Martijn L.
AU - Dutch Fenestrated Anaconda Research Group
AU - Tielliu, Ignace F.J.
AU - Reijnen, Michel M.P.J.
AU - Zeebregts, Clark J.
AU - Tielliu, Ignace F.J.
AU - Geelkerken, Robert H.
AU - Meerwaldt, Robert
AU - Pierie, Maurice E.N.
AU - van Brussel, Jerome P.
AU - van den Haak, Ronald F.
AU - Schurink, Geert Willem H.
AU - van Herwaarden, Joost A.
AU - Lardenoije, Jan Willem
AU - Reijnen, Michel M.P.J.
AU - Jahrome, Abdelkarime K.
AU - Balm, Ron
AU - Klemm, Peter L.
AU - Witte, Marianne E.
AU - Waasdorp, Evert J.
AU - Schlejen, Peter M.
AU - van Rijn, Marie Josee
AU - Verhagen, Hence J.M.
N1 - Publisher Copyright:
© 2016 Society for Vascular Surgery
PY - 2017/2
Y1 - 2017/2
N2 - Objective The fenestrated Anaconda endograft (Vascutek, Renfrewshire, Scotland) was introduced in 2010 and showed promising short-term results with high technical success and low morbidity rates. The aim of this study was to present the midterm results, with a minimum of 12 months follow-up, for all patients treated with the fenestrated Anaconda endograft in The Netherlands. Methods Patients treated with the fenestrated Anaconda endograft between May 2011 and February 2015 were included. Follow-up consisted of computed tomography angiography at 1 month and 1 year, and duplex ultrasound yearly thereafter with additional computed tomography angiography if indicated using a standard protocol. Results A total of 60 patients were included; 48 patients (80.0%) were treated for juxtarenal aneurysms, and 12 (20.0%) were short-neck infrarenal aneurysms. Mean aneurysm size was 64 ± 9 mm. A total of 140 fenestrations were incorporated. Median follow-up was 16.4 months (interquartile range, 11.9-27.4). The 30-day mortality was 3.4% (n = 2). Kaplan-Meier estimates for 1-year, 2-year, and 3-year survival were 91.4%, 89.5%, and 86.3%, respectively, without aneurysm-related mortality during follow-up. Main body primary and secondary endograft patencies were 98.3% and 100%, respectively. Target vessel primary and secondary patencies were 95.0% and 98.6%, respectively. Early type IA endoleaks occurred in seven patients (11.7%) and spontaneously resolved in all patients. At 1-year follow-up 4 (6.7%) type II endoleaks persisted. One patient experienced aneurysm rupture because of a late type III endoleak attributable to a dislodged renal stent and subsequently underwent successful conversion to open surgery. Conclusions The fenestrated Anaconda is a viable treatment option for complex abdominal aortic aneurysms. Acceptable mortality and morbidity and low reintervention rates contribute to good midterm results. Occurrence of early type I endoleak was relatively common, but these resolved spontaneously in all patients.
AB - Objective The fenestrated Anaconda endograft (Vascutek, Renfrewshire, Scotland) was introduced in 2010 and showed promising short-term results with high technical success and low morbidity rates. The aim of this study was to present the midterm results, with a minimum of 12 months follow-up, for all patients treated with the fenestrated Anaconda endograft in The Netherlands. Methods Patients treated with the fenestrated Anaconda endograft between May 2011 and February 2015 were included. Follow-up consisted of computed tomography angiography at 1 month and 1 year, and duplex ultrasound yearly thereafter with additional computed tomography angiography if indicated using a standard protocol. Results A total of 60 patients were included; 48 patients (80.0%) were treated for juxtarenal aneurysms, and 12 (20.0%) were short-neck infrarenal aneurysms. Mean aneurysm size was 64 ± 9 mm. A total of 140 fenestrations were incorporated. Median follow-up was 16.4 months (interquartile range, 11.9-27.4). The 30-day mortality was 3.4% (n = 2). Kaplan-Meier estimates for 1-year, 2-year, and 3-year survival were 91.4%, 89.5%, and 86.3%, respectively, without aneurysm-related mortality during follow-up. Main body primary and secondary endograft patencies were 98.3% and 100%, respectively. Target vessel primary and secondary patencies were 95.0% and 98.6%, respectively. Early type IA endoleaks occurred in seven patients (11.7%) and spontaneously resolved in all patients. At 1-year follow-up 4 (6.7%) type II endoleaks persisted. One patient experienced aneurysm rupture because of a late type III endoleak attributable to a dislodged renal stent and subsequently underwent successful conversion to open surgery. Conclusions The fenestrated Anaconda is a viable treatment option for complex abdominal aortic aneurysms. Acceptable mortality and morbidity and low reintervention rates contribute to good midterm results. Occurrence of early type I endoleak was relatively common, but these resolved spontaneously in all patients.
UR - http://www.scopus.com/inward/record.url?scp=85006013327&partnerID=8YFLogxK
U2 - 10.1016/j.jvs.2016.08.092
DO - 10.1016/j.jvs.2016.08.092
M3 - Article
C2 - 28029566
AN - SCOPUS:85006013327
SN - 0741-5214
VL - 65
SP - 303
EP - 310
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
IS - 2
ER -