The Use of the Off-the-Shelf Inner Branch E-nside Endograft for the Treatment of Elective and Emergent Complex Aortic Aneurysms-A Single-Center Experience.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
24 Jul 2023
Historique:
received: 04 06 2023
revised: 28 06 2023
accepted: 12 07 2023
pubmed: 27 7 2023
medline: 27 7 2023
entrez: 26 7 2023
Statut: aheadofprint

Résumé

The aim of this single-center study was to evaluate the early results of the off-the-shelf inner branch E-nside endograft in the treatment of complex aortic aneurysms and thoracoabdominal aortic aneurysms. We performed a retrospective analysis of a prospectively maintained database of all patients treated with the E-nside endograft at our institution during the years 2021-2023. Parameters evaluated were technical success, early major adverse events, target vessel patency, and the presence of endoleaks. In total 16 patients underwent treatment with the E-nside endograft. Six additional patients were evaluated for the device but were excluded due to anatomical considerations. Mean age was 71 (range 59-84) and 14 (88%) were males. Mean aneurysm diameter was 66 mm (range 54-85). Aneurysms treated included thoracoabdominal in 9 (56%), juxtarenal aneurysms in 5 (31%), postdissection aneurysm in 1 (6%) and a type 1A endoleak after a failed endovascular aneurysm repair in 1 (6%). Five of the treated aneurysms were symptomatic. A total of 58 side branches were placed into target visceral arteries. Mean operative time was 190 min (range 150-360). Technical success was achieved in 15/16 of the patients (94%). At 30 days, 1 perioperative mortality and 3 major adverse events occurred, 2 of them branch related. The E-nside endograft is a feasible option for the treatment of a broad spectrum of aortic pathologies. As it is an off-the-shelf device, it can be used selectively in elective and emergent settings with acceptable 30-day mortality and morbidity. Further follow-up is required to determine the durability of this treatment option and patency of side branches.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this single-center study was to evaluate the early results of the off-the-shelf inner branch E-nside endograft in the treatment of complex aortic aneurysms and thoracoabdominal aortic aneurysms.
METHODS METHODS
We performed a retrospective analysis of a prospectively maintained database of all patients treated with the E-nside endograft at our institution during the years 2021-2023. Parameters evaluated were technical success, early major adverse events, target vessel patency, and the presence of endoleaks.
RESULTS RESULTS
In total 16 patients underwent treatment with the E-nside endograft. Six additional patients were evaluated for the device but were excluded due to anatomical considerations. Mean age was 71 (range 59-84) and 14 (88%) were males. Mean aneurysm diameter was 66 mm (range 54-85). Aneurysms treated included thoracoabdominal in 9 (56%), juxtarenal aneurysms in 5 (31%), postdissection aneurysm in 1 (6%) and a type 1A endoleak after a failed endovascular aneurysm repair in 1 (6%). Five of the treated aneurysms were symptomatic. A total of 58 side branches were placed into target visceral arteries. Mean operative time was 190 min (range 150-360). Technical success was achieved in 15/16 of the patients (94%). At 30 days, 1 perioperative mortality and 3 major adverse events occurred, 2 of them branch related.
CONCLUSIONS CONCLUSIONS
The E-nside endograft is a feasible option for the treatment of a broad spectrum of aortic pathologies. As it is an off-the-shelf device, it can be used selectively in elective and emergent settings with acceptable 30-day mortality and morbidity. Further follow-up is required to determine the durability of this treatment option and patency of side branches.

Identifiants

pubmed: 37495095
pii: S0890-5096(23)00528-9
doi: 10.1016/j.avsg.2023.07.100
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Daniel Silverberg (D)

The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel. Electronic address: Daniel.silverberg@sheba.gov.il.

Avner Bar Dayan (A)

The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel.

Chen Speter (C)

The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel.

Michal Fish (M)

The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel.

Moshe Halak (M)

The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, The Sackler School of Medicine, Tel Aviv, Israel.

Classifications MeSH