Endovascular aortic repair of complex abdominal aorta aneurysm with Incraft endograft system: a single center experience
10.3760/cma.j.cn112434-20230822-00039
- VernacularTitle:Incraft覆膜支架治疗复杂瘤颈腹主动脉瘤单中心应用经验
- Author:
Xiaofeng HAN
1
;
Guangrui LIU
;
Tiezheng LI
;
Xiaohai MA
;
Xi GUO
Author Information
1. 首都医科大学附属北京安贞医院介入诊疗科，北京 100029
- Keywords:
Abdominal aortic aneurysm;
Endovascular aortic repair;
Severe infrarenal neck;
Endoleak
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(5):277-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To report a single-center experience with the Cordis Incraft endograft with low-profile in abdominal aortic aneurysms (AAAs) with severe infrarenal neck.Methods:All patients underwent EVAR with Incraft stent grafts between September 2019 and September 2022, were prospectively enrolled, and retrospectively analyzed. Anatomical details of the proximal aortic neck were evaluated, divided into the severe infrarenal neck (SIN, 13 cases) and normal infrarenal neck (NIN, 50 cases) groups. Early endpoints were intraoperative unplanned cuff or coil embolism, technical success (TS), 30-day morbidity/mortality, and reinterventions. Follow-up endpoints were occurrence of endoleaks, endograft migration, branch stent/ iliac stent-graft stenosis or occlusion, reintervention. The postoperative endoleak, aneurysm sac shrinkage, patency of iliac stent-graft/branch stent, and freedom from reinterventions between the two groups were compared.Results:A total of sixty-three patients were enrolled in this trial, all of whom were successfully treated. There was no significant difference in patient and lesion characteristics, excluding aneurysm neck length, neck angle and maximum aneurysm sac diameter. Proximal aneurysm neck length was shorter in the SIN group [(9.9±8.3)mm vs. (29.6±12.3)mm, P<0.001] and the neck angle was more tortile in the SIN group [(39.1±30.4)°vs.(25.1±15.4)°, P=0.036], as well maximum sac diameter was larger in the SIN group [(57.5±13.4)mm vs. (45.5±12.4)mm, P=0.016]. Although the results showed no differences between the two groups regarding the oversize rate of the main body stent graft, endoleak in operative and perioperative period, as well the hospital stay, the operative time was significantly longer in the SIN group [(96.36±31.83)min vs. (63.58±26.68)min, P=0.001]. Over the 3 years of follow-up (median time, 18 months), there were significant differences between the two groups regarding the complication occurrence of endoleak, renal stent or iliac stent-graft stenosis/occlusion ( P=0.012), and reintervention ( P=0.044). Conclusion:Data from this trial demonstrated excellent early and mid-term outcomes of EVAR using Incraft stent grafts, including severe infrarenal neck, with acceptable safety and efficacy in the short and middle terms.
