Single-centre experience with the Gore C3 Excluder stent-graft in 200 consecutive patients.
BACKGROUND
To present short and mid-term outcomes from 200 consecutive patients treated with the new C3 Gore Excluder stent-graft in a single institution.


METHODS
All patients treated with the C3 Excluder stent-graft between August 2010 and October 2015 in our institution were included in a prospective database. Treatment indication, intraoperative stent-graft repositioning, technical success, operative mortality and morbidity, survival, endoleak, complications, reintervention during follow-up were analyzed.


RESULTS
A total of 200 patients (175 male, mean age 72.4±9.2 years) were enrolled, including 180 for aortic aneurysms. Mean aortic aneurysm diameter was 57±10.8 mm, and mean neck length 27.9±11.6 mm. One hundred and eighty four cases were elective and 16 acute. Technical success was achieved in 196 (98%) patients. In three patients a small type I endoleak persisted at completion angiography, but disappeared at the first postoperative CTA. One patient presenting with a ruptured aortic plaque after branched repair of a type III thoracoabdominal aneurysm died intraoperatively. Stent-graft repositioning was performed in 89 (44.5%) patients with a total of 127 repositioning events. Adverse events related to repositioning were noticed in three cases, but repaired by endovascular means. Thirty-day mortality was zero for elective cases and 2/16 (12.5%) for acute cases accounting for an overall mortality of 1%. Mean follow-up time was 17.8±16.6 months (range 0-62 months). Ten patients died during follow-up, one from an aneurysm-related cause (aortoenteric fistula). Cumulative survival was 97.2±1.4% at 1 year, and 89.6±3.4% at 3 years. No migration, type I/ III endoleak, nor limb occlusion was detected during follow-up. Estimated freedom from reintervention was 92.4±2.2% at 1 year, and 89.9±2.8% at 3 years.


CONCLUSIONS
In this patient cohort, the C3 Excluder stent-graft provided excellent early and mid-term outcomes with null 30-day mortality in elective cases, and null type I endoleak and limb occlusion during follow-up. The option for repositioning was frequently utilized. Excessive repositioning resulted in three adverse events, all three successfully treated by endovascular means.
Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany - kthanassos@yahoo.com.
Athanasios
A
Katsargyris
Hozan
H
Mufty
Roxana
R
Wojs
Genevieve
G
Utech
Eric L
EL
Verhoeven
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016208:Databases, Factual; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D011446:Prospective Studies; D011474:Prosthesis Design; D012086:Reoperation; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome