EVAR Using the Nellix Sac-anchoring Endoprosthesis: Treatment of Favourable and Adverse Anatomy

Krievins, DK; Holden, Andrew; Savlovskis, Janis; Calderas, Carlos; Ce, Donayre; Moll, F.L.; Katzen, Barry T.; Zarins, C K

doi:10.1016/j.ejvs.2011.03.007

Cited by 115 publications

(100 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Nellix® endoprosthesis (Endologix Inc, Irvine, California, USA) has been used to treat numerous patients with abdominal aortic aneurysms (AAA) [1][2][3]. The use of a sac-anchoring endograft such as the Nellix® has brought a change in the approach to aneurysm exclusion.…”

Section: Introductionmentioning

confidence: 99%

Migration of the Nellix endoprosthesis

England

Torella

Fisher

et al. 2016

Journal of Vascular Surgery

View full text Add to dashboard Cite

PURPOSE: To report the incidence and sequelae of migration of the Nellix® endoprothesis following endovascular aneurysm sealing (EVAS).METHOD: A review was performed of the follow-up imaging of all EVAS patients in a University Hospital endovascular programme who had a minimum follow-up of one year. Using the first post-operative and latest follow-up CT scans, the distances between the proximal and distal borders of the stent-grafts relative to reference vessels were measured using a previously validated technique. Device migration was based on previously established criteria and defined as any stent-graft movement of ≥ 4 mm related to a predefined reference vessel. Device movement in a caudal direction was given a positive value (+) whereas movement in a cranial direction was denoted by a negative sign (-).RESULTS: 18 patients (35 stent-grafts) were eligible for inclusion in this retrospective review.The mean (SD; range) pre-operative AAA diameter and aortic neck length were 57 (5; 50 to 67) mm and 30 (16; 6 to 62) mm, respectively. Proximal migration, according to study definitions, was identified in six stent-grafts (17%), all in a caudal direction. At one year the mean (SD; range) proximal migration distance was +6.6 (1.6; +4.7 to +9.2) mm. Migration occurred in a single stent-graft in four patients and bilaterally in one. Distally, there were no cases of migration.CONCLUSIONS: Proximal migration of the Nellix® endoprosthesis does occur and in our series was without any sequelae. Further investigations into the long-term positional stability of the Nellix® device are required together with a more thorough understanding of the aetiology and consequences of migration.

show abstract

Section: Introductionmentioning

confidence: 99%

Migration of the Nellix endoprosthesis

England

Torella

Fisher

et al. 2016

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…Such technology might be employed in the setting of an infrarenal AAA with adverse anatomic features. 97,98 In a prospective clinical trial published in 2011, perioperative aneurysm-related mortality was 2.9% among 34 patients undergoing AAA with sac anchoring. 98 One patient had a secondary procedure because of an endoleak.…”

Section: Devices and Techniques Not Yet Fda Approvedmentioning

confidence: 99%

“…97,98 In a prospective clinical trial published in 2011, perioperative aneurysm-related mortality was 2.9% among 34 patients undergoing AAA with sac anchoring. 98 One patient had a secondary procedure because of an endoleak. CT surveillance for >2 years revealed no change in aneurysm size, no new endoleaks, and no change in stent graft position.…”

Section: Devices and Techniques Not Yet Fda Approvedmentioning

confidence: 99%

Endovascular treatment of abdominal aortic aneurysms

et al. 2013

View full text Add to dashboard Cite

Patients with abdominal aortic aneurysms (AAAs) are usually treated with endovascular aneurysm repair (EVAR), which has become the standard of care in many hospitals for patients with suitable anatomy. Clinical evidence indicates that EVAR is associated with superior perioperative outcomes and similar long-term survival compared with open repair. Since the randomized, controlled trials that provided this evidence were conducted, however, the stent graft technology for infrarenal AAA has been further developed. Improvements include profile downsizing, optimization of sealing and fixation, and the use of low porosity fabrics. In addition, imaging techniques have improved, enabling better preoperative planning, stent graft placement, and postoperative surveillance. Also in the past few years, fenestrated and branched stent grafts have increasingly been used to manage anatomically challenging aneurysms, and experiments with off-label use of stent grafts have been performed to treat patients deemed unfit or unsuitable for other treatment strategies. Overall, the indications for endovascular management of AAA are expanding to include increasingly complex and anatomically challenging aneurysms. Ongoing studies and optimization of imaging, in addition to technological refinement of stent grafts, will hopefully continue to broaden the utilization of EVAR.

show abstract

“…The new technologies early results show that the endoleak complications and migration of the proximal part of the stent will lessen soon, which are the disadvantages of the method which also rises the cost expenses of the method (8).…”

Section: Case Reportmentioning

confidence: 99%

“…They also have the advantage that they could be placed at very short necks below the infrarenal aneurysm free aortic segments compressing the aortic wall with silicone fillings found at the proximal segments of the graft stents (6,7).…”

Section: Case Reportmentioning

confidence: 99%