Technical and Clinical Outcome of Talent versus Endurant Endografts for Endovascular Aortic Aneurysm Repair

Abstract

ObjectiveThe technical evolution of endografts for the interventional management of infrarenal abdominal aortic aneurysms (AAA) has allowed a continuous expansion of indications. This study compares the established Talent endograft with its successor, the Endurant endograft, taking individual aortoiliac anatomy into account.MethodsFrom June 2007 to December 2010, 35 patients with AAA were treated with a Talent endograft (33 men) and 36 patients with an Endurant endograft (34 men). Aortoiliac anatomy was evaluated in detail using preinterventional computed tomography angiography. The 30-day outcome of both groups were compared regarding technical and clinical success as well as complications including endoleaks.ResultsThe Endurant group included more patients with unfavorable anatomy (kinking of pelvic arteries, p = 0.017; shorter proximal neck, p = 0.084). Primary technical success was 91.4% in the Talent group and 100% in the Endurant group (p = 0.115). Type 1 endoleaks occurred in 5.7% of patients in the Talent group and in 2.8% of those in the Endurant group (p = 0.614). Type 3 endoleaks only occurred in the Talent group (2.9% of patients; p = 0.493). Type 2 endoleaks were significantly less common in the Endurant group than in the Talent group (8.3% versus 28.6%; p = 0.035). Rates of major and minor complications were not significantly different between both groups. Primary clinical success was significantly better in the Endurant group (97.2%) than in the Talent group (80.0%) (p = 0.028).ConclusionEndurant endografts appear to have better technical and clinical outcome in patients with difficult aortoiliac anatomy, significantly reducing the occurrence of type 2 endoleaks.

Outcomes after endovascular abdominal aortic aneurysm repair are equivalent between genders despite anatomic differences in women

“…14 Even though women have smaller iliac arteries, no differences in early endograft occlusion or access-related complications were found among the ENGAGE cohort. The Endurant graft may be better suited to challenging aortoiliac anatomy 18 and may better accommodate smaller female access vessels when compared with previous devices. However, the effect of increasing operator experience and improved imaging techniques cannot be discounted.…”

Endovascular Treatment of Infrarenal Aneurysms: Comparison of the Results of Second- and Third-Generation Stent Grafts

“…The analysis of the preoperative anatomy did not report qualitative and quantitative measurements of iliac accesses. The study of Mensel et al (29) compared Endurant® and Talent®. This study on 71 patients had results only over the first 30 days.…”

Comparison of midterm results for the Talent and Endurant stent graft

“…[9][10][11] On the other hand, comparisons of the Talent and Endurant showed that the performance of the latter appears to be better. 7,12 The results of the U.S. regulatory pivotal trials of the Endurant and Talent were compared, showing favorable outcomes for the Endurant. 12,13 Although both these trials are similar in design, they are divided by a 5-year inclusion gap and have different participating centers.…”

“…A previous study by Mensel et al showed encouraging 30-day results in a small population. 7 In this study, we present midterm data to determine if durability in addition to short-term outcomes has improved as this remains one of the major drawbacks of EVAR.…”