title: Dutch experience with the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  In the past decennium, the management of short-neck infrarenal and juxtarenal aortic aneurysms with fenestrated endovascular aneurysm repair (FEVAR) has been shown to be successful, with good early and midterm results. Recently, a new fenestrated device, the fenestrated Anaconda (Vascutek, Renfrewshire, Scotland), was introduced. The aim of this study was to present the current Dutch experience with this device.
  
  
  METHODS
  A prospectively held database of patients treated with the fenestrated Anaconda endograft was analyzed. Decision to treat was based on current international guidelines. Indications for FEVAR included an abdominal aortic aneurysm (AAA) with unsuitable neck anatomy for EVAR. Planning was performed on computed tomography angiography images using a three-dimensional workstation.
  
  
  RESULTS
  Between May 2011 and September 2013, 25 patients were treated in eight institutions for juxtarenal (n = 23) and short-neck AAA (n = 2). Median AAA size was 61 mm (59-68.5 mm). All procedures except one were performed with bifurcated devices. A total of 56 fenestrations were incorporated, and 53 (94.6%) were successfully cannulated and stented. One patient died of bowel ischemia caused by occlusion of the superior mesenteric artery. On completion angiography, three type I endoleaks and seven type II endoleaks were observed. At 1 month of follow-up, all endoleaks had spontaneously resolved. Median follow-up was 11 months (range, 1-29 months). There were no aneurysm ruptures or aneurysm-related deaths and no reinterventions to date. Primary patency at 1 month of cannulated and stented target vessels was 96%.
  
  
  CONCLUSIONS
  Initial and short-term results of FEVAR using the fenestrated Anaconda endograft are promising, with acceptable technical success and short-term complication rates. Growing experience and long-term results are needed to support these findings.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Martijn L
authors.initials: ML
authors.lastname: Dijkstra
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Ignace F J
authors.initials: IF
authors.lastname: Tielliu
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands.
authors.forename: Robbert
authors.initials: R
authors.lastname: Meerwaldt
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Maurice
authors.initials: M
authors.lastname: Pierie
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
authors.forename: Jerome
authors.initials: J
authors.lastname: van Brussel
authors.affiliation: Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Geert Willem H
authors.initials: GW
authors.lastname: Schurink
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: Lardenoye
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: czeebregts@hotmail.com.
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057867:Endoleak / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000209:etiology / Q000401:mortality; D009426:Netherlands; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency