Clinical outcomes of Endurant II endovascular aortic repair in men and women

Objective Endovascular aneurysm repair (EVAR) is an approach for treating abdominal aortic aneurysms (AAA), offering a less invasive alternative to open surgical repair, which results in reduced perioperative morbidity and mortality. The Medtronic® Endurant II stent graft has been commonly used in EVAR procedures, demonstrating long-term stability and compatibility with diverse aneurysm anatomies. While smaller, single-center studies have assessed its efficacy, the influence of patient-specific factors, such as aneurysm size, aortic neck morphology and gender, on procedural success and outcomes remains under-explored. This study aims to evaluate the clinical success of the Medtronic Endurant II EVAR, focusing on gender differences, using a single-center cohort to identify patterns and predictors of successful outcomes. Methods A retrospective analysis was conducted on EVAR cases performed at Charité – Universitätsmedizin Berlin from 2016 to 2024. A total of 353 infrarenal aortic operations were reviewed, with 240 standard EVAR cases using the Medtronic Endurant II stent graft included in the study. Patients received CT-angiography pre- and post-operatively, and follow-ups were scheduled at 3, 6, and 12 months, then annually. Data on demographics, aneurysm characteristics, and perioperative and follow-up outcomes were collected and analyzed using IBM SPSS Statistics 29.0. Statistical tests such as Student's t-test, Mann-Whitney U test, Chi-square test, and Kaplan-Meier analysis were employed to evaluate survival and complication rates. Results Of the 240 patients treated with EVAR, 214 (89.2%) were male and 26 were female (10.8%). Female patients presented with higher rates of complex anatomies and smaller aortic diameters. The occurrence of endoleaks was higher in females (38.5%) compared to males (29.8%), though not statistically significant (p=0.364). The overall freedom from implant-related complications was similar across genders. Notably, endoleaks and other implant-related complications, such as limb occlusion and endograft infections, showed no significant difference between genders, suggesting that EVAR can be equally effective for both male and female patients when using the Medtronic Endurant II system. Survival rates at 3, 6, 12, and 24 months were also comparable. Conclusions The Medtronic® Endurant II stent graft provides a reliable therapeutic option for both genders in EVAR procedures. While anatomical challenges are more pronounced in females, procedural success and survival outcomes remain unaffected by gender.