Since the introduction of the first commercial endofraft to treat the abdominal aortic aneurysm in the early 1990s, there has been a continuous improvement and technology evolution making feasible to treat successfully highly complex AAA with endovascular repair. We have performed EVAR therapy in highly complex aorto-iliac aneurysm using the Aorfix(®) stent-graft system from 2009 to 2011.
Patients and methods: A retrospective review to our clinical experience was performed, comparing two groups of patients: 1. Challenging anatomy group treated with Aorfix Endograft. 2. Standard anatomy group was integrated by EVAR procedures performed in patients with aortic angulation less than 75°or non-tortuos iliac vessels.
Results: In 96.5-97% of cases a bifurcated endograft was implanted with clinical and technical succes . After 1 year follow up in most cases and at least 6 months follow up in all the series we saw successful results, with aneurysmal sac reduction or stability, 2 type II endoleaks related to lumbar arteries with sac stability and no AAA-related complications were finded in the complex anatomy group.
Conclusions: The 30 days, early-midterm and 12 months results for challenging anatomy group are identical to those finded in standard anatomy and consistent with published data, showing the performance of this endograft system in tortuous anatomies. These early results are quite promising, this particular graft, in its labeled use, is providing an excellent platform to EVAR therapy in challenging anatomies, off label to other devices currently avaliable; however, further studies are needed to evaluate the long-term results.