Reverse slider technique using the Endurant stent graft for accurate proximal sealing in hostile neck endovascular aneurysm repair

Morikage, Noriyasu; Nishimura, Jun-ichi; Mizoguchi, Takahiro; Takeuchi, Yuriko; Nagase, Takashi; Samura, Makoto; Harada, Takasuke; Aga, Kenichiro; Masuda, Munetaka; Hamano, Kimikazu

doi:10.1016/j.jvscit.2019.03.012

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Adjunctive techniques such as the push-up or reverse slider techniques have been reported in such cases with more favorable results. 18,19 Indeed, our registry showed no significant differences between the two groups in intraoperative type Ia endoleaks and only a tendency of increased type Ia endoleak postoperatively (3.3% vs 1.5%, p=0.075). Considering the significantly more proximal neck IFU violation observed in the Endurant stent graft, it demonstrates the favorable performance of the Endurant stent graft in the challenging proximal neck cases in our cohort.…”

Section: Discussionmentioning

confidence: 62%

“…Adjunctive techniques such as the push-up or reverse slider techniques have been reported in such cases with more favorable results. 18,19 Indeed, our registry showed no significant differences between the two groups in Log-rank analyses were used to compare between the Endurant and the Excluder groups. There was no significant difference in 5 year overall survival between the Endurant and the Excluder groups (69.7±3.7% vs 75.2±3.2%; p=0.926).…”

Section: Discussionmentioning

confidence: 94%

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Long-term Outcomes of the Endurant and Excluder Stent Grafts for Endovascular Aneurysm Repair in a Japanese Cohort

et al. 2022

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Purpose: To compare the long-term outcomes of the most widely used third-generation stent grafts, the Endurant and Excluder stent grafts, in Japanese patients using a multicenter registry. Materials and Methods: A retrospective analysis of endovascular aneurysm repairs for abdominal aortic and iliac artery aneurysms using either the Endurant or the Excluder stent grafts from January 2012 to July 2019 at 10 Japanese hospitals was performed. Results: A total of 332 and 378 repairs using the Endurant and Excluder stent grafts, respectively, were analyzed. Although the patients’ characteristics were generally similar in the two groups, the Endurant group exhibited significantly shorter (Endurant: 31.5±18.6 mm, Excluder: 37.4±21.0 mm; p<0.001), larger (Endurant: 22.4±4.2 mm, Excluder: 21.7±3.8 mm; p=0.029), and more reversed tapered (Endurant: 12.1%, Excluder: 5.8%; p=0.003) proximal necks. The incidence of instructions for use (IFU) violations was similar between the two groups (Endurant: 59.0%, Excluder: 54.5%; p=0.223). However, the Endurant group had significantly more proximal neck-related IFU violations (54.1% and 46.3%, respectively; p=0.039), more access-related IFU violations (8.1% and 4.0%, respectively; p=0.019), and fewer bilateral hypogastric artery embolizations (5.1% and 9.3%, respectively; p=0.035) compared with the Excluder group. The incidence of intraoperative (Endurant: 3.6%, Excluder: 3.7%; p=0.950) and perioperative complications (Endurant: 3.6%, Excluder: 3.4%, p=0.899) was equivalent in the two groups. However, there was a significantly higher incidence of postoperative type II endoleaks in the Excluder group (Endurant: 28%, Excluder: 46.0%, p<0.001). Aneurysm sac regression was more frequent in the Endurant group (Endurant: 40.7%, Excluder: 31.7%, p=0.013). The Endurant group also had significantly higher rates of sac increase (Endurant: 13.0%, Excluder: 7.7%, p=0.020). Kaplan-Meier curve and log-rank analyses revealed no statistical differences in late complications (p=0.868) and overall survival (p=0.926). Conclusions: There were no statistically significant differences between the Endurant and the Excluder stent grafts in terms of intraoperative, perioperative, and late complication rates; however, the anatomical characteristics of the patients were significantly different.

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Section: Discussionmentioning

confidence: 62%

“…Adjunctive techniques such as the push-up or reverse slider techniques have been reported in such cases with more favorable results. 18,19 Indeed, our registry showed no significant differences between the two groups in Log-rank analyses were used to compare between the Endurant and the Excluder groups. There was no significant difference in 5 year overall survival between the Endurant and the Excluder groups (69.7±3.7% vs 75.2±3.2%; p=0.926).…”

Section: Discussionmentioning

confidence: 94%

Long-term Outcomes of the Endurant and Excluder Stent Grafts for Endovascular Aneurysm Repair in a Japanese Cohort

et al. 2022

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“…4) Recently, Morikage et al reported the reverse slider technique using the Endurant stent-graft system. 11) This is a method of securing central sealing by pushing up the graft edge while placing it, and it is thought that sealing is possible even with a neck length of 10 mm. Our choice of the Excluder stent-graft system was based on previous experiences and anecdotal evidence from our center where we find it to be the most flexible and adaptable within the blood vessel, resulting in a better outcome.…”

Section: Discussionmentioning

confidence: 99%

A Case of Endovascular Aortic Repair for Abdominal Aortic Aneurysm with a Saccular Aneurysm in the Severely Angulated Proximal Landing Zone

Imai,

Mitomi,

Sato

et al. 2023

Annals of Vascular Diseases

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We report a case of endovascular aortic repair (EVAR) for the abdominal aortic aneurysm complicated by a saccular aneurysm due to a penetrating atherosclerotic ulcer in the severely angulated proximal landing zone. To secure the zone, coil embolization of the saccular aneurysm was performed before stent grafting to treat the abdominal aortic aneurysm. To precisely follow the severely angled proximal neck, we used the Excluder stent-graft system inserted by the body floss technique method instead of the stiff wire method to avoid accordion folding the proximal landing zone. These techniques may expand the indications of EVAR.

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“…The reverse slider technique was used for adequate proximal sealing. 5 ) A balloon dilatation at the proximal portion of the stent graft was then performed using Gore® Molding & Occlusion Balloon (W. L. Gore and Associates Inc., Flagstaff, AZ, USA) under nominal balloon pressure. Completion angiography revealed that the stent graft was properly placed, with no endoleak and dissection.…”

Section: Case Reportsmentioning

confidence: 99%

Type B Acute Aortic Dissection as a Perioperative Complication after an Endovascular Abdominal Aortic Repair

Natsume

Shintani

Hayahi

et al. 2021

Annals of Vascular Diseases

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Type B aortic dissection (TBAD) is a rare but catastrophic complication of endovascular aneurysm repair (EVAR). We report two cases of TBAD occurring in the perioperative period of EVAR. The intraoperative and postoperative courses were unremarkable. Routine postoperative computed tomography angiography (CTA) revealed TBAD. Conservative treatment was successful, and no adverse aortic events occurred. TBAD that occurs in the perioperative period is likely to be iatrogenic in origin, uncomplicated, and managed with medical therapy: its prognosis is better than when the condition develops in the midterm postoperative period.

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Reverse slider technique using the Endurant stent graft for accurate proximal sealing in hostile neck endovascular aneurysm repair

Cited by 6 publications

References 5 publications

Long-term Outcomes of the Endurant and Excluder Stent Grafts for Endovascular Aneurysm Repair in a Japanese Cohort

Long-term Outcomes of the Endurant and Excluder Stent Grafts for Endovascular Aneurysm Repair in a Japanese Cohort

A Case of Endovascular Aortic Repair for Abdominal Aortic Aneurysm with a Saccular Aneurysm in the Severely Angulated Proximal Landing Zone

Type B Acute Aortic Dissection as a Perioperative Complication after an Endovascular Abdominal Aortic Repair

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