title: An optimal combination for EVAR: low profile endograft body and continuous spiral stent limbs.
abstract: OBJECTIVE
  to evaluate the outcomes of EVAR performed with a new generation of bifurcated endografts and limbs.
  
  
  METHODS
  prospectively collected data from fifty consecutive patients with abdominal aortic aneurysms (AAA) treated at our institution with a Low Profile Zenith(®) bifurcated body/Zenith(®) Spiral-Z legs combo were analysed. AngioCT scans and Ultrasound exams were performed prior to discharge. Ultrasound examination was repeated 6 months after the procedure to assess endograft patency and to depict endoleaks
  
  
  RESULTS
  Median age was 70.6 years [50-88] and median ASA score was 3 [2-4]. Median aortic diameter was 56 mm [49-81]. Of the 100 external iliac access vessels, 14 had a diameter of 6 mm or lower. All endografts were successfully implanted. Post-operative Ultrasound examination and angioCT scan depicted both 1 type Ia, and 10 and 19 type 2 endoleaks respectively. An asymptomatic thrombosis of the left external iliac artery distal to the endograft limb was also depicted. 30-day mortality rate was 0%. Two patients died respectively three and four months after EVAR. Both deaths were not aneurysm related. All patients underwent an ultrasound exam 6-12 months after EVAR. All endografts main bodies and limbs were patent. Five endoleaks were depicted, all were type II endoleaks (the early type Ia endoleak had sealed spontaneously; it was confirmed by an angioCT scan). One patient presented a significant stenosis of the left iliac limb at the level of a narrow and calcified aortic bifurcation. It was successfully treated by bilateral iliac angioplasty and kissing balloon stenting.
  
  
  CONCLUSIONS
  EVAR performed with the Zenith LP main body in combination with Spiral-Z Iliac Legs is safe and effective. No limb occlusions were diagnosed at the 6 month follow up even in challenging iliac anatomies usually considered as contra indications for EVAR. Our first results are most satisfying and calling to be completed by a longer follow up.
authors.affiliation: Vascular Surgery, Hôpital Cardiologique, CHRU Lille, France.
authors.forename: G
authors.initials: G
authors.lastname: Couchet
authors.forename: B
authors.initials: B
authors.lastname: Maurel
authors.forename: J
authors.initials: J
authors.lastname: Sobocinski
authors.forename: A
authors.initials: A
authors.lastname: Hertault
authors.forename: M
authors.initials: M
authors.lastname: Le Roux
authors.forename: R
authors.initials: R
authors.lastname: Azzaoui
authors.forename: S
authors.initials: S
authors.lastname: Haulon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents