Department of Vascular Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Expert Rev Med Devices. 2014 Jul;11(4):331-40. doi: 10.1586/17434440.2014.916206. Epub 2014 Jun 5.
Endovascular aneurysm repair (EVAR) has become an established therapy for many patients with abdominal aortic aneurysms. This minimally invasive procedure has lower operative mortality and similar long-term survival rates compared to open surgical treatment. However, several patients are still unsuitable for EVAR because of their aneurysm neck or iliac artery anatomy, and secondly, re-intervention rates are higher after EVAR than after open aneurysm exclusion. Current challenges in the development of new stent grafts are to make more patients eligible for EVAR, including patients with challenging anatomy, and to decrease re-intervention rates. A range of different stent grafts now exist, and in the search for a device with the widest applicability and the least complications, the Endurant stent graft is a recent addition. This device offers wider inclusion criteria. Despite this, first results show comparable complication rates compared to other stent grafts, and long-term follow-up studies are underway.
血管内动脉瘤修复 (EVAR) 已成为许多腹主动脉瘤患者的既定治疗方法。与开放手术治疗相比,这种微创治疗具有更低的手术死亡率和相似的长期生存率。然而,由于患者的瘤颈或髂动脉解剖结构,仍有一些患者不适合 EVAR,其次,EVAR 后的再干预率高于开放动脉瘤排除术。目前,新支架移植物开发的挑战是使更多的患者有资格接受 EVAR,包括具有挑战性解剖结构的患者,并降低再干预率。目前存在多种不同的支架移植物,为了寻找一种适用范围最广、并发症最少的装置,Endurant 支架移植物是最近的一种选择。该装置提供了更广泛的纳入标准。尽管如此,最初的结果显示与其他支架移植物相比,并发症发生率相当,并且正在进行长期随访研究。