BACKGROUND: There are a number of stent-grafts in the market, designed to handle difficult anatomies during endovascular aortic repair. The aim of this study is to determine which stent-graft is the most appropriate to accommodate the majority of infra-renal aortic aneurysms cases. An additional aim is to determine what stent-graft characteristics influence the suitability of the stent-graft. RESEARCH DESIGN AND METHODS: Retrospective cohort study on the suitability of available stent-grafts for infrarenal aneurysm (AAA) repair based on real-life anatomic data. The anatomical characteristics of 235 AAA were measured manually using specialized software. All measurements were compared to the official instructions-for-use (IFU) using a purpose-specific server-side script. The proper function of the script was additionally confirmed. RESULTS: The highest suitability rate was achieved by Medtronic Endurant. The majority of stent-grafts failed to meet the respective AAA anatomy by one IFU characteristic. Stent-grafts that failed by only one IFU characteristic by ≥80% of unsuitable cases tend to have higher suitability rates. Neck dimensions and CIA diameter are the two characteristics significantly influencing the suitability rate. CONCLUSIONS: Any stent-graft with high suitability rates should be available off-the-shelf in any vascular department in order to cover the majority of cases. For challenging cases, special advantages of the stent-grafts should be taken under consideration.
BACKGROUND: There are a number of stent-grafts in the market, designed to handle difficult anatomies during endovascular aortic repair. The aim of this study is to determine which stent-graft is the most appropriate to accommodate the majority of infra-renal aortic aneurysms cases. An additional aim is to determine what stent-graft characteristics influence the suitability of the stent-graft. RESEARCH DESIGN AND METHODS: Retrospective cohort study on the suitability of available stent-grafts for infrarenal aneurysm (AAA) repair based on real-life anatomic data. The anatomical characteristics of 235 AAA were measured manually using specialized software. All measurements were compared to the official instructions-for-use (IFU) using a purpose-specific server-side script. The proper function of the script was additionally confirmed. RESULTS: The highest suitability rate was achieved by Medtronic Endurant. The majority of stent-grafts failed to meet the respective AAA anatomy by one IFU characteristic. Stent-grafts that failed by only one IFU characteristic by ≥80% of unsuitable cases tend to have higher suitability rates. Neck dimensions and CIA diameter are the two characteristics significantly influencing the suitability rate. CONCLUSIONS: Any stent-graft with high suitability rates should be available off-the-shelf in any vascular department in order to cover the majority of cases. For challenging cases, special advantages of the stent-grafts should be taken under consideration.
Entities:
Keywords:
EVAR; abdominal aneurysm; endovascular; indications for use; suitability
Authors: Shaneel R Patel; David C Ormesher; Samuel R Smith; Kitty H F Wong; Paul Bevis; Colin D Bicknell; Jonathan R Boyle; John A Brennan; Bruce Campbell; Andrew Cook; Alastair P Crosher; Rui V Duarte; Murray M Flett; Carrol Gamble; Richard J Jackson; Maciej T Juszczak; Ian M Loftus; Ian M Nordon; Jai V Patel; Kellie Platt; Eftychia-Eirini Psarelli; Peter C Rowlands; John V Smyth; Theodoros Spachos; Leigh Taggart; Claire Taylor; Srinivasa Rao Vallabhaneni Journal: BMJ Open Date: 2021-11-30 Impact factor: 2.692