Efficacy and anatomical factors of Endurant stent graft in endovascular aortic repair of abdominal aortic aneurysm with hostile neck / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To observe the safety and efficacy of Endurant stent-graft in abdominal aortic aneurysm with hostile neck,and detect the anatomic factors of hostile neck-related adverse events.METHODS: The clinical data of 144 consecutive patients of abdominal aortic aneurysm with hostile proximal neck who underwent endovascular aortic repair with Endurant stentgraft from January 2010 to January 2016 in Department of Vascular Surgery,Zhongshan Hospital,Fudan University were analyzed retrospectively.The perioperative clinical and the technical success rate as well as adverse event during follow up were observed.The anatomical factors correlated with proximal neck related adverse events were analyzed.RESULTS: The median length of follow-up was 36(1-73) months,and there were 26 cases of adverse events,with 18.1% incidence rate of adverse events.The clinical success rate was 98.6% and technical success rate 96.5%.Nineteen patients experienced proximal neck related adverse events.Univariate analysis demonstrated proximal neck length,neck angle,short neck,twist neck were anatomical factors that influenced the proximal neck related adverse events(All P<0,05).Multifactor logistic regression analysis identified that proximal neck length,neck angle,taper neck were anatomical factors significantly correlated with proximal neck related adverse events(All P<0.05).CONCLUSION: The Endurant stent graft generally presents safe and effective for the treatment of abdominal aortic aneurysm with hostile proximal neck,while patients with short,angulated and taper proximal neck warranted enhanced follow up.