Department of Interventional Radiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, United Kingdom.
Department of Interventional Radiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, United Kingdom; School of Medicine, University of Leeds, Leeds, United Kingdom.
J Vasc Interv Radiol. 2023 Nov;34(11):1938-1945. doi: 10.1016/j.jvir.2023.08.004. Epub 2023 Aug 13.
To assess the safety, technical success, and midterm outcomes of endoanchor (Heli-FX, Medtronic, Santa Rosa, California) deployment in thoracic endovascular aortic repair (TEVAR) or abdominal endovascular aortic repair (EVAR).
This single-institution, retrospective study of all endoanchor procedures was performed from February 1, 2017 to March 30, 2021. All procedures were performed percutaneously by interventional radiologists. Clinical information and outcome data were retrieved from electronic medical records. Fifty patients (14% females, n = 7; 86% males, n = 43; median age, 79 years [range, 56-93 years]) underwent Endoanchor procedures, with 349 Endoanchors implanted; 33 procedures were primary deployments (at initial stent deployment) and 17 were secondary deployments (previous stent deployment). For the primary group (4 TEVARs and 29 EVARs), indications were prophylactic (n = 30), hostile neck (n = 28), hostile distal landing zone (n = 2), and intraprocedural type 1a endoleaks (n = 3). For the secondary group (4 TEVARs and 13 EVARs), indications were graft migration (n = 8), seal zone expansion without proven endoleak (n = 7) (proximal [n = 4] or distal seal [n = 3]), and proven type 1a endoleak (n = 2).
Median number of endoanchors deployed per procedure was 7 (range, 3-10). Median time to deploy endoanchors was 22 minutes (range, 8-46 minutes). The technical success rate of Endoanchor was 99.7% (348/349). The 30-day mortality rate was 0%. The overall adverse event rate was 6% (n = 3). Reinterventions were performed in 12% of patients (n = 6). Median follow-up was 38 months (range, 2-71 months). Overall survival at 1 and 3 years was 95% and 85%, respectively. Overall freedom from type 1a endoleak at 1 and 3 years was 96% and 93%, respectively.
Endoanchor procedures are safe with excellent technical success rate and good midterm clinical outcomes.
评估在胸主动脉腔内修复术（TEVAR）或腹主动脉腔内修复术（EVAR）中使用 Endoanchor（Heli-FX，美敦力，加利福尼亚州圣罗莎）的安全性、技术成功率和中期结果。
本研究为单中心回顾性研究，纳入了 2017 年 2 月 1 日至 2021 年 3 月 30 日期间所有进行过 Endoanchor 手术的患者。所有手术均由介入放射科医生经皮进行。从电子病历中检索临床信息和结局数据。50 例患者（女性 14%，n=7；男性 86%，n=43；中位年龄 79 岁[范围 56-93 岁]）接受了 Endoanchor 手术，共植入 339 个 Endoanchor；33 例为初次植入（初次支架植入时），17 例为二次植入（先前支架植入时）。对于初次植入组（4 例 TEVAR 和 29 例 EVAR），适应证为预防性（n=30）、颈部不良（n=28）、不良远端着陆区（n=2）和术中 1a 型内漏（n=3）。对于二次植入组（4 例 TEVAR 和 13 例 EVAR），适应证为移植物迁移（n=8）、密封区扩张但无明确内漏（n=7）（近端[n=4]或远端密封[n=3]）和明确的 1a 型内漏（n=2）。
每例手术平均植入的 Endoanchor 数量为 7（范围 3-10）个。植入 Endoanchor 的中位时间为 22 分钟（范围 8-46 分钟）。Endoanchor 的技术成功率为 99.7%（348/349）。30 天死亡率为 0%。总体不良事件发生率为 6%（n=3）。12%的患者（n=6）接受了再次干预。中位随访时间为 38 个月（范围 2-71 个月）。1 年和 3 年的总体生存率分别为 95%和 85%。1 年和 3 年的 1a 型内漏无复发率分别为 96%和 93%。
Endoanchor 手术安全，技术成功率高，中期临床结局良好。
