Improvement of patient eligibility with the use of new generation endografts for the treatment of abdominal aortic aneurysms. A comparison study among currently used endografts and literature review.

BACKGROUND

Newer generation devices have attempted to accommodate a wider range of aortoiliac anatomies offering endovascular aneurysm repair (EVAR) to more patients with abdominal aortic aneurysms (AAAs). We aim to examine the anatomic suitability for the ultra-low profile Ovation endograft in our AAA patients and to compare them with other contemporary devices.

METHODS

158 consecutive AAA patients treated with EVAR or open surgical repair (OSR) were tested for EVAR eligibility according to the most commonly used endografts' instructions for use.

RESULTS

106 patients underwent EVAR and 52 OSR. EVAR eligibility was higher for the Ovation system (72%) compared to the rest of the devices (Incraft: 63%, Nellix: 60%, Endurant-II: 59%, Excluder: 55%, Zenith-Flex: 36%, Aorfix: 35%, P-value<0.001). Non-suitable proximal neck anatomy followed by access vessel inadequacy were the primary reasons for ineligibility.

CONCLUSION

New generation aortic endografts with innovative proximal sealing mechanisms and ultra-low profile delivery systems are increasing patient eligibility for EVAR.