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4. Long-Term Outcomes in Patients Managed with the Endurant TM Endograft under Elective Setting.

Author

Spanos, Konstantinos, Nana, Petroula, Volakakis, George, Kouvelos, George, Dakis, Konstantinos, Karathanos, Christos, Arnaoutoglou, Eleni, Matsagkas, Miltiadis, and Giannoukas, Athanasios

Subjects
ENDOVASCULAR aneurysm repair, ENDOVASCULAR surgery, PROPORTIONAL hazards models, ABDOMINAL aortic aneurysms, DEATH rate
Abstract

Background/Objectives: Device selection during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) remains an important issue for ensuring endograft durability. This study evaluated the early and follow-up outcomes of elective EVAR with the Endurant platform. Methods: A single-center retrospective analysis was conducted including consecutive elective EVAR procedures with the Endurant II/IIs (2008 to 2024) device. Primary outcomes were technical success, mortality and major complications at 30 days. Survival, endoleak I/III and freedom from reintervention were secondary outcomes. Cox proportional hazards models were employed for risk-adjusted follow-up outcomes. Results: In total, 361 patients were included (72.7 ± 7 years; 96% males; mean AAA diameter 62 ± 14 mm); 92% received a bifurcated device, and 89% conformed to the instructions for use. Technical success was 99.7%. Intra-operative adjunctive procedures included 4.4% proximal cuffs and 1.7% endoanchors. The thirty-day mortality rate was 0.6%, and the major complication rate was 4.1%. Survival was 81% (SE 4.8%), 72% (SE 6.4%) and 52% (SE 9.2%) at 4, 6 and 8 years, with aneurysm-related mortality at 1.7%. Freedom from endoleak Ia was 76% (SE 7.3%) at 6 years, freedom from endoleak Ib was 79% (SE 7.4%) at 7 years and freedom from endoleak III was 94% (SE 3.7%) at 5 years. Freedom from reintervention was 71% (SE 6.1%) and 55% (SE 7.9%) at 5 and 7 years, respectively. No device-related co-factor affected long-term outcomes. Conclusions: Endurant II/IIs endograft is a safe and effective EVAR solution with excellent early outcomes and low long-term aneurysm-related mortality. The need for reintervention in the long term affected less than 50% of cases. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Endovascular Repair of Ruptured Abdominal Aortic Aneurysms Using the Endurant™ Endograft.

Author

Nana, Petroula, Volakakis, George, Spanos, Konstantinos, Kouvelos, George, Bareka, Metaxia, Arnaoutoglou, Eleni, Giannoukas, Athanasios, and Matsagkas, Miltiadis

Subjects
AORTIC rupture, ENDOVASCULAR aneurysm repair, ABDOMINAL aortic aneurysms, ENDOVASCULAR surgery, ANEURYSMS
Abstract

Background: Endovascular aortic aneurysm repair (EVAR) represents a valid treatment modality for ruptured abdominal aortic aneurysms (rAAAs). This study aimed to present rAAA outcomes treated by EVAR using the Endurant endograft. Methods: A single-center retrospective analysis of consecutive patients treated with standard EVAR (sEVAR) or parallel graft (PG)-EVAR for infra- or juxta/para-renal rAAA using the Endurant endograft (1 January 2008–31 December 2023) was undertaken. The primary outcomes were technical success, mortality, and reintervention. Follow-up outcomes, including survival and freedom from reintervention, were assessed using Kaplan–Meier estimates. Results: Eighty-eight patients were included (87.5% sEVAR and 12.5% PG-EVAR). The mean aneurysm diameter was 73.3 ± 19.3 mm (71.4 ± 22.2 mm sEVAR and 81.7 ± 33.0 mm PG-EVAR). Among 77 patients receiving sEVAR, 26 (33.8%) received an aorto-uni-iliac device. All PG-EVAR patients were managed with bifurcated devices, one receiving a single PG, seven double PGS, and three triple PGs. Technical success was 98.8% (100.0% sEVAR and 90.9% PG-EVAR). The 30-day mortality was 47.2% (50.7% sEVAR and 27.3% PG-EVAR), with nine (10.2%) deaths recorded on the table. The mean time of follow-up was 13 ± 9 months. After excluding 30-day deaths, the estimated survival was 75.5% (standard error (SE) 6.9%) at 24 months. The estimated freedom from reintervention was 89.7% (SE 5.7%) at 24 months. Only one endoleak type Ia event was recorded during follow-up. Conclusions: Endurant showed high technical success rates and low rates of endoleak type Ia events and reinterventions, despite the emergent setting of repair. rAAA is still a highly fatal condition within 30 days, with an acceptable mid-term survival of 30-day survivors at 75.5%. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Complete Vascular Replacement of the Infrarenal Inferior Vena Cava and Abdominal Aorta during Post-Chemotherapy Retroperitoneal Lymph Node Dissection for a Non-Seminomatous Germ Cell Tumor

Author

Evmorfopoulos, Konstantinos, primary, Chasiotis, Georgios, additional, Barbatis, Alexandros, additional, Zachos, Ioannis, additional, Kouvelos, George, additional, Bareka, Metaxia, additional, Vlachostergios, Panagiotis J., additional, Arnaoutoglou, Eleni, additional, Tzortzis, Vassilios, additional, and Matsagkas, Miltiadis, additional

Published
2023
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14. The Role of Aortic Volume in the Natural History of Abdominal Aortic Aneurysms and Post-Endovascular Aortic Aneurysm Repair Surveillance.

Author

Kouvelos, George, Volakakis, George, Dakis, Konstantinos, Spanos, Konstantinos, and Giannoukas, Athanasios

Subjects
*ABDOMINAL aortic aneurysms, *AORTIC aneurysms, *NATURAL history, *AORTA, *VOLUMETRIC analysis
Abstract

There has been a debate about whether maximum diameter can be solely used to assess the natural history of abdominal aortic aneurysm. The aim of the present review is to collect all the available evidence on the role of abdominal aortic aneurysm (AAA) volume in the natural history of AAAs, including small untreated AAAs and AAAs treated by EVAR. The current literature appears to reinforce the role of volume as a supplementary measure for evaluating the natural history of AAA, in both intact AAAs and after EVAR. The clinical impact of AAA volume measurements remains unclear. Several studies show that volumetric analysis can assess changes in AAAs and predict successful endoluminal exclusion after EVAR more accurately than diameter. However, most studies lack strict standardized measurement criteria and well-defined outcome definitions. It remains unclear whether volumetry could replace diameter assessment in defining the risk of rupture of AAAs and identifying clinically relevant sac growth. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Colour Duplex and/or Contrast-Enhanced Ultrasound Compared with Computed Tomography Angiography for Endoleak Detection after Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Author

Karaolanis, Georgios I., primary, Antonopoulos, Constantine N., additional, Georgakarakos, Efstratios, additional, Lianos, Georgios D., additional, Mitsis, Michail, additional, Glantzounis, Georgios K., additional, Giannoukas, Athanasios, additional, and Kouvelos, George, additional

Published
2022
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37. Reply

Author

Spanos, Konstantinos, primary, Behrendt, Christian-Alexander, additional, Kouvelos, George, additional, Giannoukas, Athanasios D., additional, and Kölbel, Tilo, additional

Published
2021
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43. Female Sex and Outcomes after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Propensity Score Matched Cohort Analysis

Author

Behrendt, Christian-Alexander, primary, Kreutzburg, Thea, additional, Kuchenbecker, Jenny, additional, Panuccio, Giuseppe, additional, Dankhoff, Mark, additional, Spanos, Konstantinos, additional, Kouvelos, George, additional, Debus, Sebastian, additional, Peters, Frederik, additional, and Kölbel, Tilo, additional

Published
2021
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