title: [Nellix® endovascular aneurysm sealing (EVAS) - a new technology for endovascular management of infrarenal aortic aneurysms].
abstract: BACKGROUND
  Recently used endografts for envascular aneurysm repair (EVAR) exclude the pathology by fixation at both the proximal and distal landing zone. Due to endoleaks and migration EVAR is associated with a relevant rate of secondary interventions. The Nellix® system (Endologix Inc., CA, USA) was developed to seal the complete aneurysm using a polymer filling, therefore stabilising endograft-position and reducing the rate of endoleaks and reinterventions. The present contribution introduces the method, describes the technique of implantation and presents the first clinical results. Material und Methods: The Nellix system consists of two balloon-expandable stent grafts made of a cobalt-chromium composition, surrounded with ePTFE and the so-called endobags. During the implantation each endobag is filled with a non-biodegradable polymer, sealing the aneurysm lumina including the proximal and distal landing zone. Hence, lumbar arteries will be sealed to reduce the probability of a type II endoleak.
  
  
  RESULTS
  Longterm durability as well as the structural integrity of the Nellix system has been proven over 4 years in sheep experiments. The technical success in a multicentre, prospective registry was 94% without the appearance of severe adverse events (migration, occlusion, secondary endoleak).
  
  
  CONCLUSIONS
  EVAS is a new and different concept of endovascular AAA repair. Recent clinical data of the Nellix system are promising showing a high technical success rate while the need for secondary intervention is low. Further studies in larger cohorts are needed.
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Böckler
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: A S
authors.initials: AS
authors.lastname: Peters
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Pfeiffer
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Kovacs
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Geisbüsch
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: M S
authors.initials: MS
authors.lastname: Bischoff
authors.affiliation: Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinik, Heidelberg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Müller-Eschner
authors.forename: M
authors.initials: M
authors.lastname: Hakimi
authors.affiliation: Klinik für Gefäßchirurgie und Endovasculäre Chirurgie, Universitätsklinik Heidelberg, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Pfeiffer
mesh_terms: D000818:Animals; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D002858:Chromium Alloys; D000068456:Clinical Studies as Topic; D057867:Endoleak / Q000517:prevention & control*; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000517:prevention & control*; D011474:Prosthesis Design; D015607:Stents
chemical_list: D002858:Chromium Alloys; D011138:Polytetrafluoroethylene