Edgar Luis Galiñanes1,2, Eduardo Hernandez3,2, Zvonimir Krajcer3,2. 1. Department of Vascular Surgery, Baylor College of Medicine, Houston, Texas. 2. CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, Texas. 3. Department of Cardiology, Texas Heart Institute, Houston, Texas.
Abstract
OBJECTIVES: To present our initial experience with the use of EndoAnchors for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) with little to no infrarenal landing zone. BACKGROUND: EndoAnchors have been reported to assist in the prevention and treatment of type 1a endoleaks in patients with hostile aortic necks who undergo EVAR. METHODS: Between July 2013 and July 2014, nine patients with AAAs and short proximal aortic necks (i.e., 0-10 mm in length) underwent EVAR. In five patients, utilization of the chimney graft technique was necessary. A mean of 2.5 (range 1-4) visceral vessels underwent chimney graft. The prophylactic use of EndoAnchors was utilized in all 9 patients. The decision to use the EndoAnchors was made in the preoperative planning phase. RESULTS: Technical success was achieved in 100% of cases. In two cases, type 1a endoleaks were noted before the deployment of any EndoAnchors. In both cases, a final angiogram depicted resolution of the type 1a endoleak after insertion of the EndoAnchors. Mean follow-up time was 8 months. At 30 days, 3 months, and 6 months, 100% of the endografts remained patent and free from type 1a endoleaks. No adverse renal complications or mortality was reported. CONCLUSIONS: EndoAnchors are an applicable adjunct to EVAR as treatment for short infrarenal neck and pararenal AAAs. Further investigations are needed to determine the durability of this novel application.
OBJECTIVES: To present our initial experience with the use of EndoAnchors for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) with little to no infrarenal landing zone. BACKGROUND: EndoAnchors have been reported to assist in the prevention and treatment of type 1a endoleaks in patients with hostile aortic necks who undergo EVAR. METHODS: Between July 2013 and July 2014, nine patients with AAAs and short proximal aortic necks (i.e., 0-10 mm in length) underwent EVAR. In five patients, utilization of the chimney graft technique was necessary. A mean of 2.5 (range 1-4) visceral vessels underwent chimney graft. The prophylactic use of EndoAnchors was utilized in all 9 patients. The decision to use the EndoAnchors was made in the preoperative planning phase. RESULTS: Technical success was achieved in 100% of cases. In two cases, type 1a endoleaks were noted before the deployment of any EndoAnchors. In both cases, a final angiogram depicted resolution of the type 1a endoleak after insertion of the EndoAnchors. Mean follow-up time was 8 months. At 30 days, 3 months, and 6 months, 100% of the endografts remained patent and free from type 1a endoleaks. No adverse renal complications or mortality was reported. CONCLUSIONS: EndoAnchors are an applicable adjunct to EVAR as treatment for short infrarenal neck and pararenal AAAs. Further investigations are needed to determine the durability of this novel application.