Midterm results of the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair

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• 作者：Louise L. Blankensteijn ; BS^a ; Martijn L. Dijkstra ; MD^a ; Ignace F.J. Tielliu ; MD ; PhD^a ; Michel M.P.J. Reijnen ; MD ; PhD^b ; Clark J. Zeebregts ; MD ; PhD^a ; ^{czeebregts@hotmail.com} ; on behalf of the Dutch Fenestrated Anaconda Research Group^&lowast ; ; Clark J. Zeebregts ; MD ; PhD ; Ignace F.J. Tielliu ; MD ; PhD ; Robert H. Geelkerken ; MD ; PhD ; Robert Meerwaldt ; MD ; PhD ; Maurice E.N. Pierie ; MD ; PhD ; Jerome P. van Brussel ; MD ; PhD ; Ronald F. van den Haak ; MD ; Geert-Willem H. Schurink ; MD ; PhD ; Joost A. van Herwaarden ; MD ; PhD ; Jan-Willem Lardenoije ; MD ; PhD ; Michel M.P.J. Reijnen ; MD ; PhD ; Abdelkarime K. Jahrome ; MD ; PhD ; Ron Balm ; MD ; PhD ; Peter L. Klemm ; MD ; PhD ; Marianne E. Witte ; MD ; Evert J. Waasdorp ; MD ; PhD ; Peter M. Schlejen ; MD ; Marie Josee van Rijn ; MD ; PhD ; Hence J.M. Verhagen ; MD ; PhD
• 刊名：Journal of Vascular Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：65
• 期：2
• 页码：303-310
• 全文大小：357 K
• 卷排序：65

文摘

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.MethodsPatients 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.ResultsA 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.ConclusionsThe 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.