title: Endovascular aneurysm repair with the Ovation TriVascular Stent Graft System utilizing a predominantly percutaneous approach under local anaesthesia.
abstract: OBJECTIVE
  To present our experience with the Ovation Abdominal Stent Graft System (TriVascular Inc., Santa Rosa, CA) during endovascular aneurysm repair (EVAR) and compare results according to the type of anaesthesia.
  
  
  METHODS
  We conducted a single-centre retrospective study including patients who underwent EVAR using the Ovation endograft between May 2011 and July 2014. Outcome was evaluated regarding pre-, peri- and immediate postoperative and follow-up measures. Overall results are reported, while additional analysis was performed to compare the outcome between groups of patients undertaking either local or regional/general anaesthesia (LA vs RGA).
  
  
  RESULTS
  66 patients were included. Median follow-up was 13 months (range, 1-39 months). Median age was 72 years and median abdominal aortic aneurysm diameter was 58 mm (range, 54-100 mm). Technical success was 63 (95%), while there were 2 (3%) conversions to open surgery. A total percutaneous approach was used in 50/66 (76%) cases. Overall, 9/66 (14%) subjects suffered from any kind of morbidity. Median hospitalization was 3 days (range, 1-16 days). Immediate and midterm mortality rate was 0%. No endoleak Type I, III, IV or stent migration was observed. There were 8 (13%) Type II endoleaks. Overall, additional endovascular procedures were required in 6 (9%), while surgery was performed in 4 (6%) patients. 44 (67%) patients underwent LA and 22 (23%) RGA. Differences between groups were significant for procedural time (85 vs 107 min; p < 0.001), percutaneous access (91% vs 45%; p < 0.001) and systematic complications (2.3% vs 14%; p = 0.05).
  
  
  CONCLUSIONS
  EVAR with the use of the Ovation endograft shows promising short-term and midterm results regarding safety and effectiveness. Completion of the procedures under LA using a total percutaneous approach seems advantageous and may be used in routine practice.
  
  
  CONCLUSIONS
  The Ovation Abdominal Stent Graft System is an ultra-low profile stent graft system that allows percutaneous deployment for EVAR and offers excellent overall efficacy and safety. Totally percutaneous EVAR under LA seems advantageous and may be used as a routine with this specific endograft.
authors.affiliation: 1 Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: C V
authors.initials: CV
authors.lastname: Ioannou
authors.affiliation: 1 Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Kontopodis
authors.affiliation: 2 Interventional Radiology Unit, Radiology Department, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Kehagias
authors.affiliation: 3 Anesthesiology Department, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Papaioannou
authors.affiliation: 1 Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kafetzakis
authors.affiliation: 1 Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Papadopoulos
authors.affiliation: 1 Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Pantidis
authors.affiliation: 2 Interventional Radiology Unit, Radiology Department, University of Crete Medical School, Heraklion, Crete, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Tsetis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D000772:Anesthesia, Local; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D057867:Endoleak / Q000209:etiology; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome