title: Initial Clinical Experience with the Endologix AFX Unibody Stent Graft System for Treating Patients with Abdominal Aortic Aneurysms: A Case Controlled Comparative Study.
abstract: OBJECTIVE
  The newly designed unibody AFX endograft system for endovascular aortic aneurysm repair is the only graft with anatomical fixation to the aortic bifurcation in comparison to most other grafts that use the infrarenal neck as the main fixation point. The aim of this study was to assess the preliminary results of the AFX stent-graft system used with infrarenal aortic component and compare them with those obtained in patients treated with a well established endograft of the same material and pure infrarenal fixation as the Gore Excluder.
  
  
  METHODS
  A retrospective analysis of prospectively collected data from March 2014 to December 2014 identified 10 elective abdominal aortic aneurysm patients treated with the AFX endograft, in comparison to a matched group of 20 patients treated with the Excluder stent-graft. Endpoints included technical and clinical success, freedom from any secondary intervention, any type of endoleak and aneurysm related death.
  
  
  RESULTS
  Primary technical success was achieved in all patients and no 30-day device related complications or deaths were occurred. The two groups were similar in terms of radiation burden, contrast media, duration of the procedure, post implantation syndrome and in-hospital stay. During a median follow-up period of 23 months (range, 18-26 months) there were no differences in clinical success, freedom from reintervention and aneurysm related death. No type I endoleak was observed in either group. Five of the 6 type II endoleaks (1 in the AFX and 4 in the Excluder group) spontaneously resolved, while in only one patient (Excluder) the endoleak remained without however any change in aneurysm sac diameter (log rank=0.34).
  
  
  CONCLUSIONS
  The initial experience with the AFX stent graft system is promising, with successful aneurysm exclusion and good short-term results. Further and larger studies are needed to fully evaluate the sort as well as the long-term results.
authors.affiliation: Vascular Surgery Unit, Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece; Department of Vascular Surgery, General University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: George N
authors.initials: GN
authors.lastname: Kouvelos
authors.affiliation: Vascular Surgery Unit, Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Petroula
authors.initials: P
authors.lastname: Nana
authors.affiliation: Vascular Surgery Unit, Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Bouris
authors.affiliation: Vascular Surgery Unit, Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: Michalis
authors.initials: M
authors.lastname: Peroulis
authors.affiliation: Department of Vascular Surgery, General University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Drakou
authors.affiliation: Department of Vascular Surgery, General University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Rousas
authors.affiliation: Department of Vascular Surgery, General University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Giannoukas
authors.affiliation: Vascular Surgery Unit, Department of Surgery, School of Medicine, University of Ioannina, Ioannina, Greece; Department of Vascular Surgery, General University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Miltiadis I
authors.initials: MI
authors.lastname: Matsagkas
keywords: AFX graft; Aneurysm; Endovascular; Endovascular aortic aneurysm repair