Key result
Fenestrated Anaconda endografts demonstrate higher conformability than Zenith Fenestrated devices regarding aortic diameter changes.
Why the study?
The impact of different custom-made fenestrated endografts on vascular anatomy after endovascular aneurysm repair was unclear.
Does the Fenestrated Anaconda endograft alter vascular anatomy differently compared to the Zenith Fenestrated endograft in patients undergoing fenestrated endovascular aneurysm repair for complex abdominal aortic aneurysms?
Cohort (n=145)
Yes
Does the Fenestrated Anaconda endograft alter vascular anatomy differently compared to the Zenith Fenestrated endograft in patients undergoing fenestrated endovascular aneurysm repair for complex abdominal aortic aneurysms?
p-value: p=<0.001
The Fenestrated Anaconda endograft demonstrates higher conformability to native vascular anatomy compared to the Zenith Fenestrated endograft in patients undergoing complex abdominal aortic aneurysm repair.
Fenestrated Anaconda may alter target vessel anatomy less than Zenith Fenestrated; leaves open whether greater conformability improves branch patency or reintervention rates.
Purpose: To compare the impact of 2 commercially available custom-made fenestrated endografts on patient anatomy. Materials and Methods: The records of 234 patients who underwent fenestrated endovascular aneurysm repair for abdominal aortic aneurysm from March 2002 to July 2016 in 2 hospitals were screened to identify those who had pre- and postoperative computed tomography angiography assessments with a slice thickness of ≤2 mm. The search identified 145 patients for further analysis: 110 patients (mean age 72.4±7.1 years; 94 men) who had been treated with the Zenith Fenestrated (ZF) endograft and 35 patients (mean age 72.3±7.3 years; 30 men) treated with the Fenestrated Anaconda (FA) endograft. Measurements included aortic diameters at the level of the superior mesenteric artery (SMA) and renal arteries, target vessel angles, target vessel clock positions, and the target vessel tortuosity index. Variables were tested for inter- and intraobserver agreement. Results: There was a good agreement between observers in all tested variables. The native anatomy changed in both groups after endograft implantation. In the ZF group, changes were seen in the angles of the celiac artery (p=0.012), SMA (p=0.022), left renal artery (LRA) (p<0.001), and the right renal artery (RRA) (p<0.001); the aortic diameter at the SMA level (p<0.001); and the LRA (p<0.001) and RRA (p<0.001) clock positions. In the FA group, changes were seen in the angles of the LRA (p=0.001) and RRA (p<0.001) and in the SMA tortuosity index (p=0.044). Between group differences in changes were seen for the aortic diameters at the SMA and renal artery levels (p<0.001 for both) and the LRA clock position (p=0.019). Conclusion: Both custom-made fenestrated endografts altered vascular anatomy. The data suggest a higher conformability of the Fenestrated Anaconda endograft compared with the Zenith Fenestrated.
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Niet et al. (2020) conducted a cohort in Complex Abdominal Aortic Aneurysms (n=145). Fenestrated Anaconda (FA) endograft vs. Zenith Fenestrated (ZF) endograft was evaluated on Changes in vascular anatomy including aortic diameters, target vessel angles, clock positions, and tortuosity index (p=<0.001). The Fenestrated Anaconda endograft demonstrated higher conformability compared with the Zenith Fenestrated endograft, with significant differences in aortic diameter changes (p<0.001).
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