by Birger Mensel, Jens-Peter Kühn, Tobias Träger, Martin Dührkoop, Wolfram v. Bernstorff, Christian Rosenberg, Andreas Hoene, Ralf Puls
The 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. Methods
From 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. Results
The 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). Conclusion
Endurant endografts appear to have better technical and clinical outcome in patients with difficult aortoiliac anatomy, significantly reducing the occurrence of type 2 endoleaks.