Low-Profile Altura Endograft System for Endovascular Abdominal Aorta Aneurysm Repair. Preliminary Results in Elective and Emergent Situations

Georgios I Karaolanis; Demetrios Hadjis; Evangelia Samara; Ilias P Gomatos; Petros Tzimas; Georgios K Glantzounis

doi:10.1016/j.avsg.2023.01.004

Low-Profile Altura Endograft System for Endovascular Abdominal Aorta Aneurysm Repair. Preliminary Results in Elective and Emergent Situations

Ann Vasc Surg. 2023 May:92:188-194. doi: 10.1016/j.avsg.2023.01.004. Epub 2023 Jan 11.

Authors

Georgios I Karaolanis¹, Demetrios Hadjis², Evangelia Samara³, Ilias P Gomatos⁴, Petros Tzimas³, Georgios K Glantzounis⁵

Affiliations

¹ Vascular Unit, Department of Surgery, University Hospital of Ioannina and School of Medicine, Ioannina, Greece. Electronic address: g.karaolanis@uoi.gr.
² Vascular Unit, Department of Surgery, University Hospital of Ioannina and School of Medicine, Ioannina, Greece.
³ Department of Anesthesia and Postoperative Intensive Care, University of Ioannina, Faculty of Medicine, School of Health Sciences, Ioannina, Greece.
⁴ Kidney Transplantation Unit, Laiko General Hospital of Athens, Athina, Greece.
⁵ Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, University of Ioannina, School of Health Sciences, Ioannina, Greece.

PMID: 36639096
DOI: 10.1016/j.avsg.2023.01.004

Abstract

Background: The objective of this study was to assess the Altura endoprosthesis outcomes up to 12 months for patients affected by infrarenal abdominal aortic aneurysms (AAA) either in elective or emergent situations.

Methods: This was a single-center retrospective study identifying all patients undergoing endovascular aneurysm repair (EVAR) with the Altura endoprosthesis from January 2021 to August 2022. Outcomes evaluated included mortality, technical and clinical success (freedom from procedure-related death, endoleak, migration, thrombosis, and reintervention), and the freedom from reintervention rate.

Results: A total of 34 (25 elective and 8 emergent) patients who underwent AAA with Altura endoprosthesis were retrospectively reviewed. The technical success of the Altura endograft either in elective or emergent situations was 100%. There was no inhospital mortality, but 1 (3%) patient who underwent AAA repair emergently, died unexpectedly 7 days after the discharge due to massive pulmonary embolism. The clinical success and the freedom from reintervention during the median follow-up of 12 months (interquartile range [IQR] 12-18), were 97%. One patient presented with disabling intermittent claudication at third month postoperatively, and the computed tomographic angiography (CTA) revealed thrombosis of one of the iliac endografts (3%). The patient underwent femorofemoral bypass with an uneventful postoperative course and immediate relief of the symptoms. One type II endoleak was spontaneously resolved on the sixth month. Sac shrinkage (>3 mm) was registered in 12 patients (35%), but the sac size was stable in the remaining 22 (65%) patients.

Conclusions: The preliminary outcomes of the Altura endograft seem to be promising, suggesting that the endograft could be safely used either in elective or emergent situations. Further studies with a major number of participants are needed to document its technical and clinical performance, especially in emergency situations that could be amenable to improvement.

MeSH terms

Aortic Aneurysm, Abdominal* / diagnostic imaging
Aortic Aneurysm, Abdominal* / surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects
Endoleak / diagnostic imaging
Endoleak / etiology
Endoleak / surgery
Endovascular Procedures* / adverse effects
Humans
Prosthesis Design
Retrospective Studies
Risk Factors
Treatment Outcome