Suitability study of current endovascular aortic repair devices based on real-life anatomic data

ABSTRACT

Background: There are a number of stent-grafts in the market, designed to handle difficult anatomies during endovascular aortic repair. The aim of this study is to determine which stent-graft is the most appropriate to accommodate the majority of infra-renal aortic aneurysms cases. An additional aim is to determine what stent-graft characteristics influence the suitability of the stent-graft.

Research design and methods: Retrospective cohort study on the suitability of available stent-grafts for infrarenal aneurysm (AAA) repair based on real-life anatomic data. The anatomical characteristics of 235 AAA were measured manually using specialized software. All measurements were compared to the official instructions-for-use (IFU) using a purpose-specific server-side script. The proper function of the script was additionally confirmed.

Results: The highest suitability rate was achieved by Medtronic Endurant. The majority of stent-grafts failed to meet the respective AAA anatomy by one IFU characteristic. Stent-grafts that failed by only one IFU characteristic by ≥80% of unsuitable cases tend to have higher suitability rates. Neck dimensions and CIA diameter are the two characteristics significantly influencing the suitability rate.

Conclusions: Any stent-graft with high suitability rates should be available off-the-shelf in any vascular department in order to cover the majority of cases. For challenging cases, special advantages of the stent-grafts should be taken under consideration.

KEYWORDS:

• EVAR
• endovascular
• abdominal aneurysm
• suitability
• indications for use

Declaration of interest

N Patelis is one of the founders of the non-profit Med-PIE group. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

N D Patelis: Concept, manuscript writing, data collection, measurements, script development. A Malli: data collection, measurements. K S Mylonas: data collection, critical review of paper. D Schizas: measurements, critical review of paper. N Papa: data collection, measurements. K P Economopoulos: data collection, critical review of paper. C Damaskos: manuscript writing and preparation of tables/figures. K Moulakakis: data collection, measurements. A Katsargyris: measurements, critical review of paper. S Georgopoulos: data collection, critical review of paper. C Klonaris: data collection, measurements, critical review of paper. T Liakakos: critical review of paper, overall responsibility.

Additional information

Funding

This paper was not funded.