Device-specific outcomes after endovascular abdominal aortic aneurysm repair.
Over the last decade, endovascular aneurysm repair (EVAR) has been used extensively for the elective treatment of infra-renal abdominal aneurysms. However, it remains unclear how specific devices perform and how they compare to others. We provide an overview of currently used endografts, and discuss the current evidence regarding device-specific outcomes. Published literature confirms differences in results according to endograft selection. These differences were more pronounced with older generations of devices, in comparison to newer models. Contemporary results are generally good and one should remember that no randomized data exist regarding individual device performance. Moreover, by the time there is enough follow-up to draw conclusions, the data is relatively obsolete due to constant improvements in endograft technology and design. Results from EVAR have been steadily improving and individualized device selection has shown to be valuable. It appears that patients with favorable anatomy do well with most modern endografts. Those with challenging anatomies may benefit more from a particular design, delivery and deployment feature requiring greater knowledge and experience for adequate device selection.
Bastos Goncalves
F
F
Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands. f.bastosgoncalves@erasmusmc.nl
Rouwet Ellen
V
V
Metz
R
R
Hendriks
J M
JM
Vrancken Peeters
M -P F M
M-
Muhs
B E
BE
Verhagen
H J M
HJ
D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D019317:Evidence-Based Medicine; D006801:Humans; D018579:Patient Selection; D011474:Prosthesis Design; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome