title: Two-year-results of Endurant stent-graft in challenging aortic neck morphologies versus standard anatomies.
abstract: OBJECTIVE
  The aim of this paper was to evaluate the influence of a challenging neck on mid-term results using the Endurant I stent-graft system in high risk patients.
  
  
  METHODS
  A retrospective study was conducted on a prospectively compiled database of 72 elective patients with challenging neck treated with the Endurant I system (Endurant Stent Graft, Medtronic AVE, Santa Rosa, CA, USA). These patients were compared to a control group (65 patients) without significant neck problems. The endpoints were mid-term 2-years technical, clinical success and the event free survival of all treated patients.
  
  
  RESULTS
  Mean age was 76.12 years; 76.6% of patients were males. Risk factors and preoperative variables did not differ significantly between the two groups. Only 4 (5.5%) patients of the study group vs. 2 (3.1%) in the control group developed type I endoleak during the follow-up. Three (4.1%) study group patients developed type III endoleak vs. 2 (3.1%) in the control group. All these patients required an adjunct procedure of relining with a new endograft. No type II endoleaks requiring adjunctive endovascular procedures were detected in our series. The 2-year event free survival rate did not differ statistically between the two groups (P=0.425).
  
  
  CONCLUSIONS
  Treatment with the Endurant stent-graft is technically feasible and safe, yielding satisfactory results even in challenging anatomies. Mid-term results are promising and challenge current opinion concerning the negative influence of challenging neck anatomy on EVAR especially after a longer follow-up.
authors.affiliation: Vascular and Endovascular Surgery Unit Department of Medical Surgical and Neurosciences University of Siena, Siena, Italy - setacci@unisi.it.
authors.forename: F
authors.initials: F
authors.lastname: Setacci
authors.forename: P
authors.initials: P
authors.lastname: Sirignano
authors.forename: G
authors.initials: G
authors.lastname: de Donato
authors.forename: G
authors.initials: G
authors.lastname: Galzerano
authors.forename: G
authors.initials: G
authors.lastname: Messina
authors.forename: S
authors.initials: S
authors.lastname: Guerrini
authors.forename: M A
authors.initials: MA
authors.lastname: Mazzei
authors.forename: C
authors.initials: C
authors.lastname: Setacci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D018572:Disease-Free Survival; D057867:Endoleak / Q000209:etiology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color