Use of Endurant Stent-Graft Aortic Extensions for the Treatment of Focal Aortic Pathology

Background To describe our experience with the endovascular treatment of focal abdominal aortic pathology with an adequate distal neck length using Endurant (Medtronic) aortic extension cuffs. Methods From July 2010 to May 2015, 16 patients (14 male), with a mean age of 73.6 years (range, 59–88), were treated for focal abdominal aortic pathology using only Endurant (Medtronic) aortic cuff extensions. The indication for intervention was a saccular abdominal aortic aneurysm (AAA) in 5 patients, a fusiform aortic aneurysm in 6 patients, abdominal aortic dissection in 2 patients, an aortic juxtarenal rupture in 1 patient, a large anastomotic pseudoaneurysm of previous bifurcated open repair in 1 patient, and a juxtarenal aneurysm above a previous open AAA repair. Aortic lesions had a mean diameter of 52.9 (range, 32–90) mm. All patients were operated under local anesthesia with unilateral femoral exposure. A single 70-mm long Endurant aortic extension was deployed in 5 cases, while in the remaining 11 cases, 2 cuffs were used with the “telescopic” (double tube) technique. A chimney technique was performed in 5 cases (with a bare metal stent in the renal artery in 3 and a stent graft in the celiac artery in 2). Results The intraoperative technical success was 100% with no endoleaks on completion angiogram. There was no 30-day mortality. One patient developed acute limb ischemia immediately postoperatively and was treated successfully with thrombectomy. During a mean follow-up of 21.9 months, 1 patient died 2 months after the procedure due to cardiac arrest unrelated to his aortic operation. There was 1 early type IIb endoleak (present at the 30-day follow-up computerized tomography scan), which disappeared 10 months after the procedure. Finally, 1 patient was diagnosed with a type II endoleak and stable diameter 53 months postoperatively, while to date there are no cases of stent-graft migration. Conclusions The use of Endurant aortic extensions in aneurysms with adequate distal neck is a safe, simple, customizable, and cost-effective method which presents similar early results with standard endovascular aneurysm repair technique.

Background To describe our experience with the endovascular treatment of focal abdominal aortic pathology with an adequate distal neck length using Endurant (Medtronic) aortic extension cuffs. Methods From July 2010 to May 2015, 16 patients (14 male), with a mean age of 73.6 years (range, 59–88), were treated for focal abdominal aortic pathology using only Endurant (Medtronic) aortic cuff extensions. The indication for干预是5例患者的腹部腹动脉瘤（AAA），在6例患者的梭形主动脉瘤，2例患者的腹部主动脉术，1例患者的主动脉折断性破裂，以前的Bifurcototic andions and and and and and and and and and and an的开放式一名患者和一位均匀的一位均为一名and ant骨的修复平均直径为52.9（范围32-90）。单侧股骨暴露的局部麻醉。是100％完成的，没有内在的完成血管造影没有30天的死亡率。最后，有1名患者被诊断出患有II型内骨和稳定的直径为53个月，并且具有代表性，而迄今为止，尚无支架移植的情况。