Background: Gastropexy is used by many interventional radiologists during percutaneous image-guided gastrostomy insertion. This study compares major and minor complication rates of gastrostomy insertion with and without gastropexy at our center. Method(s): This is a retrospective observational study including adult patients who underwent image-guided gastrostomy insertion at our center from January 1st, 2015 to November 30th, 2018. The sample was divided into patients who had gastrostomy insertion with gastropexy and those without.Major and minor complication rates were assessed based on the Society of Interventional Radiology guidelines and compared using Chi-square. Result(s): A total of 830 patients [512 males (61.8%); 318 females (38.2%)] were included. Gastropexy was performed for 428 (51.6%) patients [1 anchor, 41 patients (9.6%); 2 anchors, 268 patients (62.7%); 3 anchors, 118 patients (27.5%); and 4 anchors, 1 patient (0.2%)]. The remaining 402 patients (48.4%) had no gastropexy. Technical success was achieved in 100% with and without gastropexy. A total of 143 complications occurred; 6 major and 137 minor. For those who had major complications, 2 were from gastropexy group. No significant difference was found in major (0.47% vs 1%, P=0.37), or minor complication rate (18.7% vs 14.2%, P=0.08) between gastropexy and no gastropexy groups, respectively. Furthermore, there was no significant difference when studying complication rates in relation to the number of anchors used (P= 0.32 for major complications, P= 0.57 for minor complications). Conclusion(s): No significant difference in major or minor complication rates was found between patients who underwent gastrostomy insertion with gastropexy versus without gastropexy. Furthermore, no significant difference in complications was found in relation to the number of anchors used.

but it requires special skills and long waiting time for fEVAR. Also management of type 1 endoleak is the most challenging leak to deal with. The emerging technology with endoanchores brought reasonable solution to deal with short neck using standard EVAR and to treat type 1 endoleak. Method(s): We will review the endoanchores registry and our experience in Saudi in using endoanchores as prophylactic to prevent and as therapeutic to treat type 1 endoleak. Result(s): The result from endoanchores registry and our experience is very promising. Conclusion(s): Endoanchores can be used as prophylactic in challenge neck anatomy to prevent trype 1 endoleak and as therapeutic to treat type 1 endoleak.

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