Suitability study of current endovascular aortic repair devices based on real-life anatomic data.

BACKGROUND: There are a number of stent-grafts in the market, designed to handle difficult anatomies during endovascular aortic repair. The aim of this study is to determine which stent-graft are the most appropriate to accommodate the majority of infra-renal aortic aneurysms cases. An additional aim is to determine which stent-graft characteristics influence the suitability of the stent-graft.

RESEARCH DESIGN AND METHODS: Retrospective cohort study on the suitability of available stent-grafts for infrarenal aneurysm (AAA) repair based on real-life anatomic data. The anatomical characteristics of 235 AAA were measured manually using specialized software. All measurements were compared to the official instructions-for-use (IFU) using a purpose-specific server-side script. Proper function of the script was additionally confirmed.

RESULTS: The highest suitability rate was achieved by Endurant. The majority of stent-grafts failed to meet the respective AAA anatomy by one IFU characteristic. Stent-grafts failing by only one IFU characteristic by >80% of unsuitable cases seem to have higher suitability rates. Neck dimensions and CIA diameter are the characteristics significantly influencing the suitability rate.

CONCLUSIONS: Any stent-graft with high suitability rates should be available off-the-shelf in any vascular department in order to cover the majority of cases. For challenging cases, special advantages of the stent-grafts should be taken under consideration.