Global Experience With the Nellix Endosystem for Ruptured and Symptomatic Abdominal Aortic Aneurysms

Reijnen, Michel M.P.J.; Bruin, Jorg L. de; Mathijssen, Elke; Zimmermann, Eric; Holden, Andrew; Hayes, Paul D.; Krieviņš, Dainis; Böckler, Dittmar; Vries, J.P.P.M. de; Thompson, Matt

doi:10.1177/1526602815618492

Cited by 31 publications

(24 citation statements)

References 30 publications

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“…7e9 Subsequent publications have reported successful use outside the original IFU, in combination with parallel stents (chimney EVAS or ChE-VAS), 10 for the salvage for failed conventional EVAR 11 and for ruptured AAA. 8 All papers have relatively short follow up (<2 years). Despite seemingly favourable results, there has been progressive and substantial refinement with regard to the device IFU such that the morphological suitability for on-label EVAS has been considerably narrowed.…”

Section: Introductionmentioning

confidence: 99%

Editor's Choice – Mid-term Migration and Device Failure Following Endovascular Aneurysm Sealing with the Nellix Stent Graft System – a Single Centre Experience

Harrison

Winterbottom

Coughlin

et al. 2018

European Journal of Vascular and Endovascular Surgery

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Section: Introductionmentioning

confidence: 99%

Editor's Choice – Mid-term Migration and Device Failure Following Endovascular Aneurysm Sealing with the Nellix Stent Graft System – a Single Centre Experience

Harrison

Winterbottom

Coughlin

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…In spite of these difficulties and although there is few experience by treatment the ruptured abdominal aortic aneurysma with the Nellix endosystem and in especially in conjunction with the chimney procedure [14,15], we decided to use the Nellix ® endosystem for both reasons: (i) to allow for secure sealing of the aortic rupture side as well as the insufficiency of the proximal anastomosies side and (ii) to safely seal potential gutters around the renal stentgrafts.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Aneurysm Sealing (EVAS) in Combination with the Chimney Technique for the Treatment of Aortic Allograft Rupture

Rustum¹,

Meyer²,

Hinrichs³

et al. 2017

Vasc Med Surg

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Case ReportWe report on the case of a pleasant 62-year old male patient, who was admitted to an external hospital 2 years ago due to acute lower back pain. Further work up revealed a 9 cm juxtarenal aortic aneurysm so that the patient was scheduled for open aneurysm repair. However, the intraoperative course was complicated due to accidental damage of the duodenum and the jejunum so that the abdomen was closed without aortic repair. Additionally he underwent re-laparotomy for cholecystectomy and partial resection of the duodenum and the jejunum a few weeks later. Subsequently it was attempted to treat the aortic aneurysm by endovascular implantation of an aorto-biiliac stentgraft (COOK inc., Bloomington, IN, USA). However, unfortunately the stentgraft could not be placed within the left iliac artery so that intraoperatively it was decided to occlude the left common iliac artery with a vascular plug and to perform a femorofemoral crossover bypass instead.Four months following this complicated course the patient was admitted to our hospital due a suspected infection of the aortic endograft as well as an endoleak type Ia. Beside, meanwhile the aortic aneurysm had grown to a maximal diameter of 13 cm. Due to multiple previous laparotomies we chose a retroperitoneal surgical approach removed all stentgrafts, the femoro-femoral crossover bypass as well as the left iliac vascular plug and placed an aorto-bi-iliac allograft. Following an uneventful perioperative course the patient could be discharged in good physical condition on the 34 th post-op day with appropriate antibiotics and antifungal for the next 6 weeks.Another nine months later, the patient presented in the external hospital again because of a 3 cm measuring aneurysm of the right common iliac artery (could not be reached/treated via the retroperitoneal approach). Another stentgraft was placed and following an initially uneventful course the patient was discharged from hospital again. However, starting shortly thereafter the patient complained about left-sided lower back pain with increasing intensity so that he was re-admitted to the external hospital again. A computed tomography angiography revealed a rupture at the left posterior side of the aortic homograft in direct extension of the left iliac stent graft and thus, leading to the assumption, that the homograft might have been puncture damaged by a guide wire at the time of stenting the right iliac artery (Figure 1). Furthermore, an insufficiency at the proximal allograft anastomosis site was suspected so that the patient was admitted to our hospital again for further treatment. Directly after arrival at our institution laboratory work up reveled an elevated C-reactive protein (252.5 mg/L) and a slowly decreasing hemoglobin level (8.4 g/dL), but leukocytes within normal range (6.8 Tsd/µL).Given the complicated surgical history with multiple previous trans-and retroperitoneal abdominal surgical interventions leading to a hostile abdomen and despite a potential graft infection due to AbstractWe report on a...

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“…Therefore, when Nellix was launched few years ago, there was a high expectation on limiting the rate of type II endoleaks. Nevertheless, the device did not perform at the standards that it was initially expected, probably because in most of the cases it was used outside the instructions for use (IFU) [40–43]. Specifically, the IFU instructed aortic proximal neck diameter range of 18 to 28 mm, minimum aortic proximal neck length ≥ 10 mm, proximal aortic neck angulation of ≤ 60°, aortic aneurysm with a blood lumen diameter ≤ 70 mm, ratio of maximum aortic aneurysm diameter to maximum aortic blood lumen diameter < 1.4, and distal iliac artery seal zone with length of ≥10 mm and diameter range of 9 to 25 mm.…”

Section: Type II Endoleaksmentioning

confidence: 99%

Techniques and future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms

et al. 2019

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The presence of endoleaks remains one of the main drawbacks of endovascular repair of abdominal aortic aneurysms leading to the increase of the size of the aneurysmal sac and in most of the cases to repeated interventions. A variety of devices and percutaneous techniques have been developed so far to prevent and treat this phenomenon, including sealing of the aneurysmal sac, endovascular embolisation, and direct sac puncture. The aim of this review is to analyse the indications, the effectiveness, and the future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms.

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Global Experience With the Nellix Endosystem for Ruptured and Symptomatic Abdominal Aortic Aneurysms

Abstract: EVAS in the acute setting appears safe and feasible and concordant with the literature for endovascular aneurysm repair. More robust prospective and comparative data are required to establish the position of the technique in the treatment algorithm of acute AAA.

Cited by 31 publications

References 30 publications

Editor's Choice – Mid-term Migration and Device Failure Following Endovascular Aneurysm Sealing with the Nellix Stent Graft System – a Single Centre Experience

Editor's Choice – Mid-term Migration and Device Failure Following Endovascular Aneurysm Sealing with the Nellix Stent Graft System – a Single Centre Experience

Endovascular Aneurysm Sealing (EVAS) in Combination with the Chimney Technique for the Treatment of Aortic Allograft Rupture

Techniques and future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms

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