title: Two-year outcome of the Endurant stent graft for endovascular abdominal aortic repair in Japanese patients: incidence of endoleak and aneurysm sac shrinkage.
abstract: BACKGROUND
  We aimed to review 50 consecutive Japanese abdominal aortic aneurysm (AAA) and common iliac aneurysm (CIAA) patients to evaluate the 2-year outcomes, particularly endoleak and aneurysm sac shrinkage, of the Endurant stent graft.
  
  
  METHODS
  Between June 2012 and January 2014, 50 consecutive Japanese AAA and CIAA patients underwent EVAR with the Endurant stent graft. Clinical outcomes of overall survival, aneurysm-related survival, and secondary intervention-free survival were analyzed; endoleaks and aneurysm sac changes were also evaluated.
  
  
  RESULTS
  The 2-year Kaplan-Meier estimates for overall survival, aneurysm-related survival, and secondary intervention-free survival were 85.4%, 97.7% with one device-related death, and 84.9%, respectively. Type I, II, and III endoleaks at any one point (all comers) after EVAR were detected in 2 (4%), 6 (12%), and 3 (6%) patients, respectively, whereas type IV endoleak was detected in 19 (38%) patients. The percentage of patients with significant sac shrinkage was only 19% (7/37) of the patients at 2 years. Multivariate analysis detected hypertension as a significant factor affecting aneurysm sac shrinkage (OR: 0.09, 95% CI: 0.001-0.99, P=0.049).
  
  
  CONCLUSIONS
  The Endurant stent graft has demonstrated consistently successful clinical performance in Japanese patients for 2 years. However, the incidence of type IV endoleak was high, while the percentage of significant sac shrinkage was low. Careful and longer follow-up is required to determine the durability of the Endurant stent graft in Japanese patients.
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan - toshiyanishibe@yahoo.co.jp.
authors: Toshiya
authors: T
authors: Nishibe
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Toru
authors: T
authors: Iwahashi
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Kentaro
authors: K
authors: Kamiya
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Kayo
authors: K
authors: Toguchi
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Keita
authors: K
authors: Maruno
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Toshiki
authors: T
authors: Fujiyoshi
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Yukio
authors: Y
authors: Muromachi
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Shun
authors: S
authors: Suzuki
authors: Department of Diagnostic Radiology, Tokai University School of Medicine, Isehara, Japan.
authors: Jun
authors: J
authors: Koizumi
authors: Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan.
authors: Hitoshi
authors: H
authors: Ogino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000503:physiopathology; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D057867:Endoleak / Q000453:epidemiology*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery*; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D014160:Transducers, Pressure; D016896:Treatment Outcome