Background: Device selection for endovascular treatment of abdominal aortic aneurysms (AAAs) with necks >60° is challenging. We sought to identify whether such anatomy necessitated graft oversizing during (endovascular aneurysm repair [EVAR]), and whether this increased the risk of type 1A endoleaks.
Methods: Prospective analysis of patients undergoing implantation of a C3 Gore Excluder, with aortic anatomy defined as outside Instructions for Use (IFU) due to proximal neck angulation >60° was performed.
Results: Of the 1,394 patients enrolled, 127 patients (9.2%) were included, with median follow-up of 236 days. Mean neck angle was 78.0 ± 13.2%, neck length 2.88 ± 1.31, and mean graft oversize 23.5 ± 9.6%. There were 7 type 1A endoleaks (5.5% males, 5.6% females). Neither neck length, angle, nor degree of oversizing were predictors of type IA endoleak.
Conclusions: In conclusion, when selecting endografts for patients with proximal neck angulation over 60°, endovascular interventionalists are not adhering to IFU. However, this was not associated with increased risk of type 1A endoleaks.
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