One-Year European Experience Reported for EVAR With Medtronic's Endurant Stent Graft

December 23, 2009—In the Journal of Vascular and Interventional Radiology, Giovanni Torsello, MD, et al published findings from a study conducted to assess preliminary results of the Endurant stent graft (Medtronic, Inc., Minneapolis, MN), which was developed to treat patients with abdominal aortic aneurysms (AAAs) and challenging aortoiliac anatomy (2010;21:73–80). The investigators concluded that the early and 1-year results from this European multicenter experience show that the Endurant stent graft appears to be effective in endovascular repair of AAAs in patients with hostile aortoiliac anatomy. The device permits a broader group of patients to be treated with endovascular aneurysm repair; however, further studies are needed to evaluate the long-term results, the investigators advised.

As detailed in the Journal of Vascular and Interventional Radiology, 45 patients with AAAs were treated with the Endurant stent graft in three European vascular centers from November 2007 to October 2008. Thirty-eight of the 45 patients (84%) had a hostile anatomy of the proximal neck. Early (30 days), early midterm (6 months), and late midterm (1 year) results were analyzed in terms of technical success, clinical success, morbidity, and mortality.

The investigators reported that intraoperative immediate technical and clinical success was achieved in all cases. At completion angiography, a type II endoleak was detected in seven of the 45 patients (16%), and an iliac limb stenosis was diagnosed and successfully treated in five patients (11%). At discharge, computed tomography demonstrated a type I endoleak in one of the 45 patients (2.2%). At 30 days, a graft limb thrombosis was diagnosed (2.2%) and successfully treated. The 30-day overall technical and clinical success rates were 97.8% (44 of 45 cases) and 95.6% (43 of 45 cases), respectively. During follow-up (mean duration, 8 months; range, 5–16 months), the type I endoleak was successfully treated with an aortic extension. Estimated freedom from types I or III endoleak and repeat intervention at 1 year was 97.8% (44/45 cases) and 93.3% (42/45 cases), respectively.