O159: Designed to Respect and Repair the Abdominal Aorta: A 9-year International Experience with the Fenestrated Anaconda Endograft

Background Endovascular aortic repair (EVAR) has become the mainstay treatment for abdominal aortic aneurysms and is associated with optimal clinical outcomes. However, there remains a risk of complications requiring reintervention. Several EVAR devices exist commercially, yet, the Terumo Aortic Fenestrated Anaconda™ (FA) has demonstrated outstanding results. Methods The current study represents a 9-year cross-sectional international analysis of custom-made FA. Data was collected prospectively in 27 countries and stored in a registry. This was later retrieved and analysed retrospectively. Results A total of 5058 patients received the FA endograft. This was indicated either due to complex anatomy for competitor devices (n = 3891, 76.9%) or based on surgeon preference (n = 1167, 23.1%). Overall, the FA was utilised to rescue 3466 (68.5%) failed previous EVARs using competitor devices. The predominant device category and proximal ring stent configuration were bifurcate (83.6%) and standard (64.5%). Most were delivered within 6-8 weeks (55.4%) of diagnosis and 95% came with a prototype. As for clinical outcomes, both survival and TVP were 100% during the first 6 postoperative years but dropped to 77.1% and 81% thereafter. A sac regression of 0-30% was observed in 4772 (94.3%) over the first 4 years, whilst all patients had 20-45% sac regression afterwards. No cases of endograft migration or reintervention were recorded. All clinical outcomes were further stratified by indication group. Conclusion The custom-made FA endograft features a highly unique and innovative design which enables it to treat highly complex aortic anatomy while achieving favourable results.