Spanos Konstantinos, Nana Petroula, Volakakis George, Kouvelos George, Dakis Konstantinos, Karathanos Christos, Arnaoutoglou Eleni, Matsagkas Miltiadis, Giannoukas Athanasios
Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece.
German Aortic Centre, Department of Vascular Medicine, University Heart and Vascular Centre UKE Hamburg, 20246 Hamburg, Germany.
J Clin Med. 2024 Sep 21;13(18):5601. doi: 10.3390/jcm13185601.
: Device selection during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) remains an important issue for ensuring endograft durability. This study evaluated the early and follow-up outcomes of elective EVAR with the Endurant platform. : A single-center retrospective analysis was conducted including consecutive elective EVAR procedures with the Endurant II/IIs (2008 to 2024) device. Primary outcomes were technical success, mortality and major complications at 30 days. Survival, endoleak I/III and freedom from reintervention were secondary outcomes. Cox proportional hazards models were employed for risk-adjusted follow-up outcomes. : In total, 361 patients were included (72.7 ± 7 years; 96% males; mean AAA diameter 62 ± 14 mm); 92% received a bifurcated device, and 89% conformed to the instructions for use. Technical success was 99.7%. Intra-operative adjunctive procedures included 4.4% proximal cuffs and 1.7% endoanchors. The thirty-day mortality rate was 0.6%, and the major complication rate was 4.1%. Survival was 81% (SE 4.8%), 72% (SE 6.4%) and 52% (SE 9.2%) at 4, 6 and 8 years, with aneurysm-related mortality at 1.7%. Freedom from endoleak Ia was 76% (SE 7.3%) at 6 years, freedom from endoleak Ib was 79% (SE 7.4%) at 7 years and freedom from endoleak III was 94% (SE 3.7%) at 5 years. Freedom from reintervention was 71% (SE 6.1%) and 55% (SE 7.9%) at 5 and 7 years, respectively. No device-related co-factor affected long-term outcomes. : Endurant II/IIs endograft is a safe and effective EVAR solution with excellent early outcomes and low long-term aneurysm-related mortality. The need for reintervention in the long term affected less than 50% of cases.
在腹主动脉瘤（AAA）的血管内动脉瘤修复术（EVAR）中，设备选择仍然是确保血管内移植物耐久性的重要问题。本研究评估了使用Endurant平台进行择期EVAR的早期和随访结果。：进行了一项单中心回顾性分析，纳入了连续使用Endurant II/IIs（2008年至2024年）设备进行的择期EVAR手术。主要结局为30天时的技术成功率、死亡率和主要并发症。生存、I/III型内漏和无需再次干预为次要结局。采用Cox比例风险模型进行风险调整后的随访结局分析。：总共纳入了361例患者（72.7±7岁；96%为男性；平均AAA直径62±14mm）；92%接受了分叉型设备，89%符合使用说明。技术成功率为99.7%。术中辅助操作包括4.4%的近端袖带和1.7%的腔内锚定器。30天死亡率为0.6%，主要并发症发生率为4.1%。4年、6年和8年时的生存率分别为81%（标准误4.8%）、72%（标准误6.4%）和52%（标准误9.2%），动脉瘤相关死亡率为1.7%。6年时Ia型内漏发生率为76%（标准误7.3%），7年时Ib型内漏发生率为79%（标准误7.4%），5年时III型内漏发生率为94%（标准误3.7%）。5年和7年时无需再次干预的比例分别为71%（标准误6.1%）和55%（标准误7.9%）。没有与设备相关的协变量影响长期结局。：Endurant II/IIs血管内移植物是一种安全有效的EVAR解决方案，早期结局良好，长期动脉瘤相关死亡率低。长期需要再次干预的病例不到50%。
