Efficacy of the JOTEC E-tegra Stent Graft System in endovascular repair of abdominal aneurysms: our experience

BACKGROUND: Endovascular repair of aortic aneurysm (EVAR) is a minimally invasive and effective technique for treating aorto-iliac aneurysms. In recent years, modern technology has allowed the development of increasingly advanced stent grafts, making the procedures less invasive and improving technical success and mortality rates, while reducing mid- and long-term complications. The E-tegra endoprosthesis is an FDA- approved bimodular device consisting of a main body and a contralateral leg. Its flexibility and adaptability allow it to treat difficult vascular anatomies. The aim of this study is to evaluate the results of using the JOTEC E-tegra stent graft system during EVAR in patients with aorto-iliac aneurysms.METHODS: We conducted a retrospective, single-center clinical study involving 62 patients referred to our institution between January 2020 and October 2023 (76.1±5.3 years; 54 men, eight women). Indications included infrarenal abdominal aortic or aorto-iliac aneurysms (mean diameter 54±4.3 mm). Of these, 50 patients underwent standard EVAR (all within the IFU) with the JOTEC E-tegra endoprosthesis, eight patients also underwent coil embolization to exclude hypogastric aneurysms, two patients were also treated with the JOTEC E-liac iliac branch due to extension of disease to the iliac bifurcation, four patients had an isolated iliac aneurysm and were therefore treated with the JOTEC E-liac iliac branch only. The primary endpoint of the study was the development of early type I and type III endoleaks. The secondary endpoints were the occurrence of iliac branch occlusion and the development of late type II endoleaks.RESULTS: All procedures were completed successfully. No deaths nor need for surgical conversion were reported. There were no type I ELs. The rate of type IIIa EL was 1.6% (1 of 62 patients was further treated for disconnection of the iliac branch from the main body). Only three patients had a type II EL with a significant (>5 mm) increase in the aneurysmal sac and required embolization. Only one patient presented with iliac branch occlusion requiring reintervention. The mean follow-up was 18 months.CONCLUSIONS: The use of JOTEC E-tegra stent grafts for endovascular exclusion of aorto-iliac aneurysms showed good results in terms of technical success with low rates of major complications in a small cohort of patients. Further studies and longer follow-up are needed to confirm these promising results.