Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”
The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for...
Gespeichert in:
| Veröffentlicht in: | Annals of vascular surgery 2022-03, Vol.80, p.37-49 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 49 |
|---|---|
| container_issue | |
| container_start_page | 37 |
| container_title | Annals of vascular surgery |
| container_volume | 80 |
| creator | D'Oria, Mario Galeazzi, Edoardo Veraldi, Gian Franco Garriboli, Luca Saccà, Salvatore Farneti, Fabrizio Mezzetto, Luca Mastrorilli, Davide Lepidi, Sandro Gorgatti, Filippo Taglialavoro, Jacopo Calvagna, Cristiano Griselli, Filippo Ziani, Barbara Balestrieri, Giovanni Di Pinto, Luca Calia |
| description | The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for increased failure rates.
A retrospective review of all consecutive patients who had undergone elective or non-elective EVAR with the Bolton Treo endograft at 5 institutions located in the North-East of Italy (January 2016–December 2020) was performed. The main exposure variable for this study was presence of hostile (HAN) or friendly (FAN) aortic neck.
A total of 137 consecutive patients were treated with the Bolton Treo endograft at participating institutions; of these 63 (46%) presented HAN while 74 (54%) had FAN. At baseline, no significant differences were observed in the distribution of demographics and comorbidities between study groups. Two type Ia endoleaks (EL) were detected at completion angiography, all in patients with HAN but none in patients with FAN (3% vs. 0%, P = 0.04), but no type III EL were identified in the whole cohort. The median duration of follow-up in the study cohort was 30 months (IQR 22–34 months) and was similar between study groups (P = 0.87). At 3-years, survival estimates were 89% and 91% (P= 0.82) in patients with HAN and FAN, respectively. At three years, patients with HAN had significantly lower freedom from type IA endoleak as compared with patients with FAN (87% vs. 94%, P= 0.02). No significant differences were found between study groups in the three-year estimates of freedom from reinterventions (80% vs. 86%, P= 0.28). Using cox proportional hazards, presence of type II EL (HR 3.15, 95%CI 1.18–8.5, P= 0.02) and presence of type IA EL (HR 4.22, 95%CI 1.39–12.85, P= 0.01) were found as independent predictors for reinterventions in univariate analysis, although they were no longer significant in the multivariate model. Freedom from sac increase >5mm at three years were not significantly different between study groups (92% vs 91%, P= 0.95).
Within a contemporary multicentric real-world experience, EVAR with the Bolton Treo endograft shows a satisfactory safety profile in the immediate postoperative phase and acceptable outcomes during mid-term follow-up. Presence of HAN is correlated with development of type Ia EL (either early following stent-graft implantation or late after EVAR) which, in turn, may represent a significant |
| doi_str_mv | 10.1016/j.avsg.2021.08.059 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2596016047</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0890509621007937</els_id><sourcerecordid>2596016047</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-3c3b46992170759bbbf8dcb4a06d6abeebc0a19ddbc5ece51186fc7e212ab7d23</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhQMC0aHwAiyQl-0iwc7kV2KTlmkZaTpBZRBLy7FvZlzieLCdKbPrg8DL9UlwmBZ2rKwr3fOdY90TBG8Ijggm2bubiO3sOopxTCJcRDgtnwYTkpE0TMskfxZMcFHiMMVldhS8tPYGYxIXSfEiOJomeRoXKZk8OZ2rLeMO6RZ9MvqHVKxDS-DfUNUzp9Ue6R593mjjwhUYhVgv0JUUh6EeHNcKLKpaBwatDDCnoP8Dqxqhlew9rfJiyT0PBrO3yqKv0m28x214CT0Y5qS3WOjb0Pu3sgM064VeG9Y6G6FrsEPnLLowWiG3AXTlR8m9ifHM-7uf81XVSdajpXfZhDNmndespXVmP8aYLT_UO2b50DHzmOQatkyaQ4wReVZ3ru7H-PqfNzrx5HCUn9X16vT-7ter4HnLOguvH97j4MvFbHX-MVzUl_PzahHyaZq5cMqnTZKVZUxynKdl0zRtIXiTMJyJjDUADceMlEI0PAUOKSFF1vIcYhKzJhfx9Dg4OXC3Rn8fwDqqpOXQdawHPVgap2Xmr4-T3K_Gh1VutLUGWro1_oJmTwmmY0XoDR0rQseKUFxQXxEvevvAHxoF4q_ksRN-4f1hAfwvdxIMtVxCz0FIA9xRoeX_-L8BjhPTdw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2596016047</pqid></control><display><type>article</type><title>Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>D'Oria, Mario ; Galeazzi, Edoardo ; Veraldi, Gian Franco ; Garriboli, Luca ; Saccà, Salvatore ; Farneti, Fabrizio ; Mezzetto, Luca ; Mastrorilli, Davide ; Lepidi, Sandro ; Gorgatti, Filippo ; Taglialavoro, Jacopo ; Calvagna, Cristiano ; Griselli, Filippo ; Ziani, Barbara ; Balestrieri, Giovanni ; Di Pinto, Luca Calia</creator><creatorcontrib>D'Oria, Mario ; Galeazzi, Edoardo ; Veraldi, Gian Franco ; Garriboli, Luca ; Saccà, Salvatore ; Farneti, Fabrizio ; Mezzetto, Luca ; Mastrorilli, Davide ; Lepidi, Sandro ; Gorgatti, Filippo ; Taglialavoro, Jacopo ; Calvagna, Cristiano ; Griselli, Filippo ; Ziani, Barbara ; Balestrieri, Giovanni ; Di Pinto, Luca Calia ; The ITA-ENDOBOOT registry collaborators ; ITA-ENDOBOOT registry collaborators</creatorcontrib><description>The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for increased failure rates.
A retrospective review of all consecutive patients who had undergone elective or non-elective EVAR with the Bolton Treo endograft at 5 institutions located in the North-East of Italy (January 2016–December 2020) was performed. The main exposure variable for this study was presence of hostile (HAN) or friendly (FAN) aortic neck.
A total of 137 consecutive patients were treated with the Bolton Treo endograft at participating institutions; of these 63 (46%) presented HAN while 74 (54%) had FAN. At baseline, no significant differences were observed in the distribution of demographics and comorbidities between study groups. Two type Ia endoleaks (EL) were detected at completion angiography, all in patients with HAN but none in patients with FAN (3% vs. 0%, P = 0.04), but no type III EL were identified in the whole cohort. The median duration of follow-up in the study cohort was 30 months (IQR 22–34 months) and was similar between study groups (P = 0.87). At 3-years, survival estimates were 89% and 91% (P= 0.82) in patients with HAN and FAN, respectively. At three years, patients with HAN had significantly lower freedom from type IA endoleak as compared with patients with FAN (87% vs. 94%, P= 0.02). No significant differences were found between study groups in the three-year estimates of freedom from reinterventions (80% vs. 86%, P= 0.28). Using cox proportional hazards, presence of type II EL (HR 3.15, 95%CI 1.18–8.5, P= 0.02) and presence of type IA EL (HR 4.22, 95%CI 1.39–12.85, P= 0.01) were found as independent predictors for reinterventions in univariate analysis, although they were no longer significant in the multivariate model. Freedom from sac increase >5mm at three years were not significantly different between study groups (92% vs 91%, P= 0.95).
Within a contemporary multicentric real-world experience, EVAR with the Bolton Treo endograft shows a satisfactory safety profile in the immediate postoperative phase and acceptable outcomes during mid-term follow-up. Presence of HAN is correlated with development of type Ia EL (either early following stent-graft implantation or late after EVAR) which, in turn, may represent a significant factor leading to reinterventions.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1016/j.avsg.2021.08.059</identifier><identifier>PMID: 34752851</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Abdominal aortic aneurysm ; Aged ; Aged, 80 and over ; Angiography ; Aorta, Abdominal - anatomy & histology ; Aortic Aneurysm, Abdominal - surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - methods ; Endoleak - epidemiology ; Endoleaks ; Endovascular aneurysm repair ; Endovascular Procedures - methods ; Female ; Humans ; Italy - epidemiology ; Male ; Neck ; Outcomes ; Postoperative Complications - epidemiology ; Prosthesis Design ; Registries ; Retrospective Studies</subject><ispartof>Annals of vascular surgery, 2022-03, Vol.80, p.37-49</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-3c3b46992170759bbbf8dcb4a06d6abeebc0a19ddbc5ece51186fc7e212ab7d23</citedby><cites>FETCH-LOGICAL-c356t-3c3b46992170759bbbf8dcb4a06d6abeebc0a19ddbc5ece51186fc7e212ab7d23</cites><orcidid>0000-0001-8537-7920 ; 0000-0002-7156-7827</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0890509621007937$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34752851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>D'Oria, Mario</creatorcontrib><creatorcontrib>Galeazzi, Edoardo</creatorcontrib><creatorcontrib>Veraldi, Gian Franco</creatorcontrib><creatorcontrib>Garriboli, Luca</creatorcontrib><creatorcontrib>Saccà, Salvatore</creatorcontrib><creatorcontrib>Farneti, Fabrizio</creatorcontrib><creatorcontrib>Mezzetto, Luca</creatorcontrib><creatorcontrib>Mastrorilli, Davide</creatorcontrib><creatorcontrib>Lepidi, Sandro</creatorcontrib><creatorcontrib>Gorgatti, Filippo</creatorcontrib><creatorcontrib>Taglialavoro, Jacopo</creatorcontrib><creatorcontrib>Calvagna, Cristiano</creatorcontrib><creatorcontrib>Griselli, Filippo</creatorcontrib><creatorcontrib>Ziani, Barbara</creatorcontrib><creatorcontrib>Balestrieri, Giovanni</creatorcontrib><creatorcontrib>Di Pinto, Luca Calia</creatorcontrib><creatorcontrib>The ITA-ENDOBOOT registry collaborators</creatorcontrib><creatorcontrib>ITA-ENDOBOOT registry collaborators</creatorcontrib><title>Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for increased failure rates.
A retrospective review of all consecutive patients who had undergone elective or non-elective EVAR with the Bolton Treo endograft at 5 institutions located in the North-East of Italy (January 2016–December 2020) was performed. The main exposure variable for this study was presence of hostile (HAN) or friendly (FAN) aortic neck.
A total of 137 consecutive patients were treated with the Bolton Treo endograft at participating institutions; of these 63 (46%) presented HAN while 74 (54%) had FAN. At baseline, no significant differences were observed in the distribution of demographics and comorbidities between study groups. Two type Ia endoleaks (EL) were detected at completion angiography, all in patients with HAN but none in patients with FAN (3% vs. 0%, P = 0.04), but no type III EL were identified in the whole cohort. The median duration of follow-up in the study cohort was 30 months (IQR 22–34 months) and was similar between study groups (P = 0.87). At 3-years, survival estimates were 89% and 91% (P= 0.82) in patients with HAN and FAN, respectively. At three years, patients with HAN had significantly lower freedom from type IA endoleak as compared with patients with FAN (87% vs. 94%, P= 0.02). No significant differences were found between study groups in the three-year estimates of freedom from reinterventions (80% vs. 86%, P= 0.28). Using cox proportional hazards, presence of type II EL (HR 3.15, 95%CI 1.18–8.5, P= 0.02) and presence of type IA EL (HR 4.22, 95%CI 1.39–12.85, P= 0.01) were found as independent predictors for reinterventions in univariate analysis, although they were no longer significant in the multivariate model. Freedom from sac increase >5mm at three years were not significantly different between study groups (92% vs 91%, P= 0.95).
Within a contemporary multicentric real-world experience, EVAR with the Bolton Treo endograft shows a satisfactory safety profile in the immediate postoperative phase and acceptable outcomes during mid-term follow-up. Presence of HAN is correlated with development of type Ia EL (either early following stent-graft implantation or late after EVAR) which, in turn, may represent a significant factor leading to reinterventions.</description><subject>Abdominal aortic aneurysm</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Aorta, Abdominal - anatomy & histology</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - methods</subject><subject>Endoleak - epidemiology</subject><subject>Endoleaks</subject><subject>Endovascular aneurysm repair</subject><subject>Endovascular Procedures - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Neck</subject><subject>Outcomes</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prosthesis Design</subject><subject>Registries</subject><subject>Retrospective Studies</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhQMC0aHwAiyQl-0iwc7kV2KTlmkZaTpBZRBLy7FvZlzieLCdKbPrg8DL9UlwmBZ2rKwr3fOdY90TBG8Ijggm2bubiO3sOopxTCJcRDgtnwYTkpE0TMskfxZMcFHiMMVldhS8tPYGYxIXSfEiOJomeRoXKZk8OZ2rLeMO6RZ9MvqHVKxDS-DfUNUzp9Ue6R593mjjwhUYhVgv0JUUh6EeHNcKLKpaBwatDDCnoP8Dqxqhlew9rfJiyT0PBrO3yqKv0m28x214CT0Y5qS3WOjb0Pu3sgM064VeG9Y6G6FrsEPnLLowWiG3AXTlR8m9ifHM-7uf81XVSdajpXfZhDNmndespXVmP8aYLT_UO2b50DHzmOQatkyaQ4wReVZ3ru7H-PqfNzrx5HCUn9X16vT-7ter4HnLOguvH97j4MvFbHX-MVzUl_PzahHyaZq5cMqnTZKVZUxynKdl0zRtIXiTMJyJjDUADceMlEI0PAUOKSFF1vIcYhKzJhfx9Dg4OXC3Rn8fwDqqpOXQdawHPVgap2Xmr4-T3K_Gh1VutLUGWro1_oJmTwmmY0XoDR0rQseKUFxQXxEvevvAHxoF4q_ksRN-4f1hAfwvdxIMtVxCz0FIA9xRoeX_-L8BjhPTdw</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>D'Oria, Mario</creator><creator>Galeazzi, Edoardo</creator><creator>Veraldi, Gian Franco</creator><creator>Garriboli, Luca</creator><creator>Saccà, Salvatore</creator><creator>Farneti, Fabrizio</creator><creator>Mezzetto, Luca</creator><creator>Mastrorilli, Davide</creator><creator>Lepidi, Sandro</creator><creator>Gorgatti, Filippo</creator><creator>Taglialavoro, Jacopo</creator><creator>Calvagna, Cristiano</creator><creator>Griselli, Filippo</creator><creator>Ziani, Barbara</creator><creator>Balestrieri, Giovanni</creator><creator>Di Pinto, Luca Calia</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8537-7920</orcidid><orcidid>https://orcid.org/0000-0002-7156-7827</orcidid></search><sort><creationdate>202203</creationdate><title>Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”</title><author>D'Oria, Mario ; Galeazzi, Edoardo ; Veraldi, Gian Franco ; Garriboli, Luca ; Saccà, Salvatore ; Farneti, Fabrizio ; Mezzetto, Luca ; Mastrorilli, Davide ; Lepidi, Sandro ; Gorgatti, Filippo ; Taglialavoro, Jacopo ; Calvagna, Cristiano ; Griselli, Filippo ; Ziani, Barbara ; Balestrieri, Giovanni ; Di Pinto, Luca Calia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-3c3b46992170759bbbf8dcb4a06d6abeebc0a19ddbc5ece51186fc7e212ab7d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal aortic aneurysm</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Aorta, Abdominal - anatomy & histology</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - methods</topic><topic>Endoleak - epidemiology</topic><topic>Endoleaks</topic><topic>Endovascular aneurysm repair</topic><topic>Endovascular Procedures - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Neck</topic><topic>Outcomes</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prosthesis Design</topic><topic>Registries</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>D'Oria, Mario</creatorcontrib><creatorcontrib>Galeazzi, Edoardo</creatorcontrib><creatorcontrib>Veraldi, Gian Franco</creatorcontrib><creatorcontrib>Garriboli, Luca</creatorcontrib><creatorcontrib>Saccà, Salvatore</creatorcontrib><creatorcontrib>Farneti, Fabrizio</creatorcontrib><creatorcontrib>Mezzetto, Luca</creatorcontrib><creatorcontrib>Mastrorilli, Davide</creatorcontrib><creatorcontrib>Lepidi, Sandro</creatorcontrib><creatorcontrib>Gorgatti, Filippo</creatorcontrib><creatorcontrib>Taglialavoro, Jacopo</creatorcontrib><creatorcontrib>Calvagna, Cristiano</creatorcontrib><creatorcontrib>Griselli, Filippo</creatorcontrib><creatorcontrib>Ziani, Barbara</creatorcontrib><creatorcontrib>Balestrieri, Giovanni</creatorcontrib><creatorcontrib>Di Pinto, Luca Calia</creatorcontrib><creatorcontrib>The ITA-ENDOBOOT registry collaborators</creatorcontrib><creatorcontrib>ITA-ENDOBOOT registry collaborators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>D'Oria, Mario</au><au>Galeazzi, Edoardo</au><au>Veraldi, Gian Franco</au><au>Garriboli, Luca</au><au>Saccà, Salvatore</au><au>Farneti, Fabrizio</au><au>Mezzetto, Luca</au><au>Mastrorilli, Davide</au><au>Lepidi, Sandro</au><au>Gorgatti, Filippo</au><au>Taglialavoro, Jacopo</au><au>Calvagna, Cristiano</au><au>Griselli, Filippo</au><au>Ziani, Barbara</au><au>Balestrieri, Giovanni</au><au>Di Pinto, Luca Calia</au><aucorp>The ITA-ENDOBOOT registry collaborators</aucorp><aucorp>ITA-ENDOBOOT registry collaborators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2022-03</date><risdate>2022</risdate><volume>80</volume><spage>37</spage><epage>49</epage><pages>37-49</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><abstract>The aim of the study was to evaluate the short-term and mid-term technical and clinical outcomes of the Bolton Treo endograft in subjects with abdominal aortic aneurysm (AAA) requiring endovascular aortic repair (EVAR) and assess if presence of hostile proximal neck would represent a risk factor for increased failure rates.
A retrospective review of all consecutive patients who had undergone elective or non-elective EVAR with the Bolton Treo endograft at 5 institutions located in the North-East of Italy (January 2016–December 2020) was performed. The main exposure variable for this study was presence of hostile (HAN) or friendly (FAN) aortic neck.
A total of 137 consecutive patients were treated with the Bolton Treo endograft at participating institutions; of these 63 (46%) presented HAN while 74 (54%) had FAN. At baseline, no significant differences were observed in the distribution of demographics and comorbidities between study groups. Two type Ia endoleaks (EL) were detected at completion angiography, all in patients with HAN but none in patients with FAN (3% vs. 0%, P = 0.04), but no type III EL were identified in the whole cohort. The median duration of follow-up in the study cohort was 30 months (IQR 22–34 months) and was similar between study groups (P = 0.87). At 3-years, survival estimates were 89% and 91% (P= 0.82) in patients with HAN and FAN, respectively. At three years, patients with HAN had significantly lower freedom from type IA endoleak as compared with patients with FAN (87% vs. 94%, P= 0.02). No significant differences were found between study groups in the three-year estimates of freedom from reinterventions (80% vs. 86%, P= 0.28). Using cox proportional hazards, presence of type II EL (HR 3.15, 95%CI 1.18–8.5, P= 0.02) and presence of type IA EL (HR 4.22, 95%CI 1.39–12.85, P= 0.01) were found as independent predictors for reinterventions in univariate analysis, although they were no longer significant in the multivariate model. Freedom from sac increase >5mm at three years were not significantly different between study groups (92% vs 91%, P= 0.95).
Within a contemporary multicentric real-world experience, EVAR with the Bolton Treo endograft shows a satisfactory safety profile in the immediate postoperative phase and acceptable outcomes during mid-term follow-up. Presence of HAN is correlated with development of type Ia EL (either early following stent-graft implantation or late after EVAR) which, in turn, may represent a significant factor leading to reinterventions.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>34752851</pmid><doi>10.1016/j.avsg.2021.08.059</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-8537-7920</orcidid><orcidid>https://orcid.org/0000-0002-7156-7827</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0890-5096 |
| ispartof | Annals of vascular surgery, 2022-03, Vol.80, p.37-49 |
| issn | 0890-5096 1615-5947 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2596016047 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Abdominal aortic aneurysm Aged Aged, 80 and over Angiography Aorta, Abdominal - anatomy & histology Aortic Aneurysm, Abdominal - surgery Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - methods Endoleak - epidemiology Endoleaks Endovascular aneurysm repair Endovascular Procedures - methods Female Humans Italy - epidemiology Male Neck Outcomes Postoperative Complications - epidemiology Prosthesis Design Registries Retrospective Studies |
| title | Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)” |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T15%3A42%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20Proximal%20Neck%20Anatomy%20on%20Short-Term%20and%20Mid-Term%20Outcomes%20After%20Treatment%20of%20Abdominal%20Aortic%20Aneurysms%20With%20New-Generation%20Low-Profile%20Endografts.%20Results%20From%20the%20Multicentric%20%E2%80%9CITAlian%20North-East%20Registry%20of%20ENDOvascular%20Aortic%20Repair%20With%20the%20BOltOn%20Treo%20Endograft%20(ITA-ENDOBOOT)%E2%80%9D&rft.jtitle=Annals%20of%20vascular%20surgery&rft.au=D'Oria,%20Mario&rft.aucorp=The%20ITA-ENDOBOOT%20registry%20collaborators&rft.date=2022-03&rft.volume=80&rft.spage=37&rft.epage=49&rft.pages=37-49&rft.issn=0890-5096&rft.eissn=1615-5947&rft_id=info:doi/10.1016/j.avsg.2021.08.059&rft_dat=%3Cproquest_cross%3E2596016047%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2596016047&rft_id=info:pmid/34752851&rft_els_id=S0890509621007937&rfr_iscdi=true |