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Nana P, Volakakis G, Spanos K, Kouvelos G, Bareka M, Arnaoutoglou E, Giannoukas A, Matsagkas M. Endovascular Repair of Ruptured Abdominal Aortic Aneurysms Using the Endurant™ Endograft. J Clin Med 2024; 13:5282. [PMID: 39274495 PMCID: PMC11396500 DOI: 10.3390/jcm13175282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 08/26/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Endovascular aortic aneurysm repair (EVAR) represents a valid treatment modality for ruptured abdominal aortic aneurysms (rAAAs). This study aimed to present rAAA outcomes treated by EVAR using the Endurant endograft. Methods: A single-center retrospective analysis of consecutive patients treated with standard EVAR (sEVAR) or parallel graft (PG)-EVAR for infra- or juxta/para-renal rAAA using the Endurant endograft (1 January 2008-31 December 2023) was undertaken. The primary outcomes were technical success, mortality, and reintervention. Follow-up outcomes, including survival and freedom from reintervention, were assessed using Kaplan-Meier estimates. Results: Eighty-eight patients were included (87.5% sEVAR and 12.5% PG-EVAR). The mean aneurysm diameter was 73.3 ± 19.3 mm (71.4 ± 22.2 mm sEVAR and 81.7 ± 33.0 mm PG-EVAR). Among 77 patients receiving sEVAR, 26 (33.8%) received an aorto-uni-iliac device. All PG-EVAR patients were managed with bifurcated devices, one receiving a single PG, seven double PGS, and three triple PGs. Technical success was 98.8% (100.0% sEVAR and 90.9% PG-EVAR). The 30-day mortality was 47.2% (50.7% sEVAR and 27.3% PG-EVAR), with nine (10.2%) deaths recorded on the table. The mean time of follow-up was 13 ± 9 months. After excluding 30-day deaths, the estimated survival was 75.5% (standard error (SE) 6.9%) at 24 months. The estimated freedom from reintervention was 89.7% (SE 5.7%) at 24 months. Only one endoleak type Ia event was recorded during follow-up. Conclusions: Endurant showed high technical success rates and low rates of endoleak type Ia events and reinterventions, despite the emergent setting of repair. rAAA is still a highly fatal condition within 30 days, with an acceptable mid-term survival of 30-day survivors at 75.5%.
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Affiliation(s)
- Petroula Nana
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
- German Aortic Centre, Department of Vascular Medicine, University Heart and Vascular Centre, UKE Hamburg, 20246 Hamburg, Germany
| | - George Volakakis
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Konstantinos Spanos
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - George Kouvelos
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Metaxia Bareka
- Department of Anaesthesiology, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Eleni Arnaoutoglou
- Department of Anaesthesiology, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Athanasios Giannoukas
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Miltiadis Matsagkas
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
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Moulakakis KG, Papadoulas S, Kakisis JD. The role of parallel grafts on the treatment of ruptured juxtarenal aortic aneurysms. VASA 2021; 50:321-322. [PMID: 34482763 DOI: 10.1024/0301-1526/a000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | - Spyros Papadoulas
- Vascular Surgery Department, Patras University Hospital, Patras, Greece
| | - John D Kakisis
- Department of Vascular Surgery, School of Medicine, National and Kapodistrian University of Athens, Attikon Teaching Hospital, Athens, Greece
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