Hull York Medical School, University of York, York, UK.
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Asian Cardiovasc Thorac Ann. 2023 Sep;31(7):582-588. doi: 10.1177/02184923221138505. Epub 2022 Nov 13.
An abdominal aortic aneurysm (AAA) is a life-threatening abnormal dilation of the abdominal aorta that can be repaired either endovascularly or with open surgery. However, endovascular aortic repair (EVAR) has become the main treatment modality for AAA due to its more optimal results. EVAR devices can either be standard, fenestrated, or branched, with fenestrated EVAR (FEVAR) seemingly achieving superior prospects. Although EVAR is associated with excellent outcomes, it still carries a risk of certain complications requiring reintervention or 'rescue'. Several commercial EVAR devices are available on the global market, nevertheless, the Fenestrated Anaconda developed by Terumo Aortic can be considered the superior device due to the wide range of endovascular solutions that it offers along with its unique custom-made approach, excellent results and its highly promising potential to be used as a 'rescue' device for failed competitor endografts.
The current study represents a 9-year cross-sectional international analysis of a custom-made Fenestrated Anaconda™ device. For the statistical analysis, SPSS 28 for Windows and R were utilised. Pearson Chi-square analysis was used to assess differences in cumulative distribution frequencies between select variables. Statistical significance for all two-tailed tests was set at < 0.05.
Out of 5058 EVARs performed using the Fenestrated Anaconda, 2987 (59%) were 'rescue' procedures for migrated Gore ( = 252) and Medtronic ( = 2735) devices. The Fenestrated Anaconda™ was indicated as the reintervention device either due to unsuitable/complex anatomy for the competitor ( = 2411) or based on surgeon preference ( = 576). Overall, the Fenestrated Anaconda was utilised to rescue 3466 (68.5%) failed previous EVARs using competitor devices. Yet, the primary endovascular solution offered by the Fenestrated Anaconda was FEVAR (91.3%), with 112 (2.2%) devices using custom-made iliac stents.
The use of the Fenestrated Anaconda endograft as a 'rescue' device to salvage failed competitor devices is well-established in the literature with excellent clinical outcomes achieved. The evidence in the literature also highlights the distinctive custom-made approach that the Fenestrated Anaconda offers which enables it to treat extremely complex aortic anatomy.
腹主动脉瘤（AAA）是一种危及生命的腹主动脉异常扩张，可以通过血管内或开放手术进行修复。然而，由于其更优的结果，血管内主动脉修复（EVAR）已成为 AAA 的主要治疗方式。EVAR 装置可以是标准的、开窗的或分支的，其中开窗 EVAR（FEVAR）似乎具有更好的前景。尽管 EVAR 具有出色的结果，但它仍然存在某些并发症的风险，需要再次介入或“抢救”。全球市场上有几种商业 EVAR 设备，但 Terumo Aortic 开发的 Fenestrated Anaconda 可被视为更优的设备，因为它提供了广泛的血管内解决方案，以及其独特的定制方法、出色的结果及其作为“抢救”设备的高应用潜力用于失败的竞争对手内移植物。
本研究代表了一种定制 Fenestrated Anaconda™ 设备的 9 年国际横断面分析。对于统计分析，使用了 Windows 版 SPSS 28 和 R。使用 Pearson Chi-square 分析评估选择变量之间的累积分布频率差异。所有双侧检验的统计显著性水平设定为 < 0.05。
在使用 Fenestrated Anaconda 进行的 5058 例 EVAR 中，有 2987 例（59%）是移植物戈尔（ = 252）和美敦力（ = 2735）的“抢救”手术。 Fenestrated Anaconda™ 被指定为再介入装置，要么是由于竞争对手的不合适/复杂解剖结构（ = 2411），要么是基于外科医生的偏好（ = 576）。总体而言， Fenestrated Anaconda 用于抢救 3466 例（68.5%）先前使用竞争对手设备的失败 EVAR。然而， Fenestrated Anaconda 提供的主要血管内解决方案是 FEVAR（91.3%），其中 112 例（2.2%）使用定制髂内支架。
Fenestrated Anaconda 移植物作为抢救失败的竞争对手设备的“抢救”装置在文献中已有很好的应用，且取得了出色的临床结果。文献中的证据还强调了 Fenestrated Anaconda 提供的独特定制方法，使其能够治疗极其复杂的主动脉解剖结构。
