Experience with physician-modified Ankura™ endografts for endovascular repair of thoracoabdominal aortic aneurysms

J Cardiovasc Surg (Torino). 2021 Jun;62(3):234-241. doi: 10.23736/S0021-9509.20.11544-1. Epub 2020 Nov 13.

Abstract

Background: The aim of this study was to evaluate the early results of fenestrated/branched endovascular aortic repair (F/B-EVAR) of thoracoabdominal aortic aneurysms (TAAAs) using physician-modified Ankura endografts (PMEGs).

Methods: Sixteen consecutive patients who underwent F/B-EVAR using PMEGs between July 2017 and December 2018 were retrospectively reviewed. The perioperative mortality and morbidity of the PMEG technique were assessed, and the early results of follow-up were evaluated.

Results: The median age of the patients was 75.3 years old (range: 48-83 years), and 12 (75.0%) patients were male. The median TAAA diameter was 7.1±1.5 cm (range: 5.1-11 cm). The initial technical success rate of vessel revascularization was 98.2% (55 of 56). Target vessel patency was 98.1% (52/53), and freedom from reintervention was 98.1% (52/53) at follow-up. The 30-day mortality rates 6.3%. There was no death during follow-up.

Conclusions: PMEGs represent an important innovation, with favorable initial results, in the treatment of patients with complex TAAAs who may be unfit for open repair. In addition, they remain a promising option for high-risk patients in need of urgent repair who cannot wait for a custom-made device.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / physiopathology
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / methods*
  • Endovascular Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Physicians*
  • Prosthesis Design
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency