Long-term results of Talent endografts for endovascular abdominal aortic aneurysm repair

Abstract

Initially, technical success of endovascular aneurysm repair (EVAR) using the Talent endograft is high, with acceptable yearly risk for AAA-related mortality and conversion. However, a substantial amount of mainly endovascular reinterventions is necessary during long-term follow-up to achieve these results.

The influence of neck thrombus on clinical outcome and aneurysm morphology after endovascular aneurysm repair

“…Despite this event, the postimplantation rupture rates in both groups were similar and compared favorably with the crude annual rupture risk of 0.7% recently reported from the EVAR studies. 18 No other AAA-related deaths or conversions to open repair were registered, and although the sample was small, it compares to the findings of larger randomized and observational studies. 2,[19][20][21] The median neck length of the thrombus group was, however, greater than generally observed in EVAR series, and that may explain why our higher migration rate did not result in a greater number of adverse clinical events.…”

“…Endografts without active fixation (ie, Talent) are more prone to migrate, as previously demonstrated. 18 The presence of thrombus may facilitate migration when radial force is the sole means of fixation. Although we cannot provide or find any robust data in the literature to support it, we currently select devices with suprarenal active fixation when neck thrombus is present and have not observed any migration in these patients.…”

Clinical outcome and morphologic analysis after endovascular aneurysm repair using the Excluder endograft

“…23 They reported similar primary clinical success rate of 64% at 5 years but a much higher estimated AAA-related mortality of 8% at 7 years and four postimplantation ruptures at a mean of 40 months, all associated with graft migration and type I endoleak. Another recent publication reported long-term outcomes using the Zenith endoprosthesis in 143 elective patients, of whom four had incomplete imaging data.…”

Long-term dilatation of polyester and expanded polytetrafluoroethylene tube grafts after open repair of infrarenal abdominal aortic aneurysms

“…The authors postulated an acceptable yearly risk for AAA-related mortality and conversion. 35 Recent evidence has reported no significant difference in long-term mortality between OSR and EVAR. 36 Nevertheless, OSR has to remain a standard procedure, which needs to be mastered by every vascular surgeon.…”