Preliminary Results of Aorfix? Stent Graft to Treat Infrarenal Abdominal Aortic Aneurysms with Severe Proximal Aortic Neck Angulation

摘要

Background We report a preliminary experience about endovascular aortic repair (EVAR) of infrarenal abdominal aortic aneurysm (iAAA) with severe proximal aortic neck angulation (NA) using the Aorfix? stent graft. Methods Data of consecutive patients with iAAA with severe proximal NA submitted to endovascular repair between September 2012 and December 2014 in 2 Italian centers of Vascular and Endovascular Surgery were retrospectively reviewed, and outcomes were analyzed using the software JMP 5.1.2. Results A total of 26 patients were treated. Median proximal NA was 87.5° (range 68–108°), and 3 patients were treated outside the instruction for use of Aorfix because of a proximal NA > 90°. Eleven patients (42.3%) had severe iliac tortuosity. The primary success rate was 92.3%, as 2 patients required intraoperative correction of a type Ia endoleak. Within 30?days, a right limb occlusion was successfully resolved with endovascular recanalization. The median follow-up period was 14?months (range 1–48?months): 1 patient died for neoplasm and 1 patient presented a type II endoleak from lumbar arteries at 3?months, which is still under surveillance. No other complications were reported during the follow-up period. Conclusions Preliminary results with the Aorfix stent graft seemed to be promising in the aim of reducing endoleak and migration rates in presence of iAAA with severe proximal aortic NA.