Endurant stent-graft: a 2-year, single-center experience with a new commercially available device for the treatment of abdominal aortic aneurysms.
OBJECTIVE
To evaluate early and midterm results of the Endurant stent-graft in the treatment of abdominal aortic aneurysms (AAAs).


METHODS
From November 2007 to December 2009, 156 patients (142 men; mean age 73.6 years, range 51-90) were treated with the Endurant stent-graft at our center. More than half (106, 67.9%) had hostile proximal neck anatomy. Early (30-day) technical success, clinical success, major morbidity, and mortality rates were analyzed, as well as estimated 2-year survival, freedom from types I/III endoleak, freedom from graft thrombosis, freedom from any device-related reinterventions, and factors affecting 2-year freedom from types I/III endoleak.


RESULTS
Immediate intraoperative technical and clinical success was achieved in all cases. In 14 (9%) cases with a proximal neck <5 mm long, a "chimney" technique was used. At discharge, computed tomography demonstrated 2 (1.3%) type I endoleaks. At 30 days, 4 (2.6%) patients had died (2 were urgent cases); the 30-day major morbidity was 7.7%. The overall 30-day technical success and clinical success rates were 98.7% and 95.5%, respectively. During a mean 9-month follow-up (range 1-24), 3 patients died (one of them from AAA rupture). Estimated survival, freedom from types I/III endoleak, freedom from graft thrombosis, and freedom from any device-related reinterventions at 2 years were 94.7%, 96.9%, 97.8%, and 92.6%, respectively.


CONCLUSIONS
The Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair (EVAR), even in patients with hostile aortoiliac anatomy. However, perioperative and midterm complications occur, which could be explained by the expansion of indications for EVAR. Further studies are needed to evaluate the long-term results.
Troisi
Nicola
N
Department of Vascular Surgery, St. Franziskus Hospital, and Center for Vascular and Endovascular Surgery, University Hospital, Münster, Germany. nicola.troisi@alice.it
Torsello
Giovanni
G
Donas
Konstantinos P
KP
Austermann
Martin
M
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome