Evaluation of Patient Selection Guidelines for Endoluminal AAA Repair With the Zenith Stent-Graft:The Australasian Experience

Abstract

Proximal neck contour, length, and diameter are the most important criteria in terms of endoleak development. Breaching the proximal neck length criterion resulted in a 4-fold increase in endoleak, and combined deviations from the guidelines multiplied the effect. Necks < or = 10 mm long are unsuitable for the standard Zenith graft.

The Aorfix Stent-Graft to Treat Infrarenal Abdominal Aortic Aneurysms With Angulated Necks and/or Tortuous Iliac Arteries:Midterm Results

“…7,18 Other commercially available endografts, such as the Zenith TriFab, Excluder, Talent, and Powerlink, have been advocated as suitable for proximal neck (and CIA) angles only up to 60u and if all other neck criteria are within the guidelines. 5,13,17,23,24 Indeed, for infrarenal neck angulations up to 60u, equivalent primary and long-term success rates can be achieved more or less with all these previously mentioned devices, although the Zenith stent-graft seems to perform better in the context of less favorable neck morphology. 8,25 The Zenith Composite and the Anaconda endografts have been suggested as potentially suitable for neck angles .60u; however, little evidence yet exists.…”

“…[12][13][14][15] Conventional wisdom is that a severely tortuous infrarenal aorta and neck angulation .60u constitute contraindications for use of the current commercially available AAA endografts. 3 However, these criteria are somewhat arbitrary, and the true limits have not been adequately tested.…”

The Zenith Aortic Stent-Graft: A 5-Year Single-Center Experience

“…[1][2][3]5,13 The evolution of the Zenith system was influenced by the problems identified in those early experiences. 4,[6][7][8][9] Conceptually, this stent-graft was based on 3 essential features incorporated into the original design, which has been enhanced over time.…”

“…Via bilateral common femoral arteriotomies, the Zenith stent-grafts were placed as previously described. 4,[6][7][8][9] Sixty-eight (77.3%) bifurcated stent-grafts, 18 of which were the TriFab system, and 20 (22.7%) aortomonoiliac devices were used. In most cases, the stent-graft was oversized 4 to 6 mm larger than the aortic implantation site and 2 to 3 mm larger than the iliac implantation sites.…”

“…The Zenith stent-graft has evolved since the first clinical trial at the Royal Perth Hospital (Australia) in 1994, with several refinements that have enhanced its functionality. 4,[6][7][8][9] Its use is now widespread in Europe and Australia, and the device is undergoing a phase II FDA trial in the United States. The aim of this study was to evaluate the efficacy of the Zenith aortic stent-graft during a 5-year singlecenter experience.…”