title: Percutaneous endovascular aneurysm repair with the ultra-low profile Ovation Abdominal Stent-Graft System.
abstract: OBJECTIVE
  Aim of the study was to report our single-center experience of the ultra-low profile OvationTM Abdominal Stent-Graft System with totally percutaneous endovascular aneurysm repair (PEVAR).
  
  
  METHODS
  Between December 2010 and March 2013 we electively treated 35 patients (male: 89%, mean age: 73±7 years) with abdominal aortic aneurysm (AAA) using bilateral PEVAR with the OvationTM endograft. Most (77%) cases were characterized by challenging femoral artery anatomy. Patients returned for follow-up visits at 1, 3, 6 months and annually thereafter.
  
  
  RESULTS
  Technical success was 97.1%. One type Ia endoleak was identified on final angiography, which was treated with an extension cuff. No groin complications were observed, including lymphocele, hematoma, pseudoaneurysm, dehiscence, or wound infection. Mean follow-up was 10 months (range 1-24 months). No death was registered. One type Ia endoleak was identified at the 12-month follow-up, which resolved with placement of a Palmaz balloon-expandible stent. No type II, III, or IV endoleaks were identified. No migration, AAA enlargement, AAA rupture, or conversion to open surgery was reported. Two patients (5.7%) developed monolateral iliac limb occlusion at 58 and 72 days of follow-up, respectively. In one case a limb kinking was observed and treated with iliac kissing stent. The other limb occlusion was due to external iliac artery severe stenosis and was treated with thrombolysis and iliac artery stenting.
  
  
  CONCLUSIONS
  PEVAR with the OvationTM endograft is feasible and safe in patients with unfavorable anatomy.
authors.affiliation: Department of Vascular Surgery San Filippo Neri Hospital, Rome, Italy. n.mangialardi@sanfilipponeri.roma.it
authors.forename: N
authors.initials: N
authors.lastname: Mangialardi
authors.forename: S
authors.initials: S
authors.lastname: Ronchey
authors.forename: H
authors.initials: H
authors.lastname: Kasemi
authors.forename: V
authors.initials: V
authors.lastname: Alberti
authors.forename: S
authors.initials: S
authors.lastname: Fazzini
authors.forename: E
authors.initials: E
authors.lastname: Serrao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057867:Endoleak / Q000209:etiology / Q000628:therapy; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome