The use of EndoAnchors in endovascular repair of abdominal aortic aneurysms with challenging proximal neck: Single-centre experience

ObjectivesThe aim of this study was to present a single-centre experience with EndoAnchors inpatients who underwent endovascular repair for abdominal aortic aneurysms withchallenging proximal neck, both in the prevention and treatment of endograft migrationand type Ia endoleaks.MethodsWe retrospectively analysed 17 consecutive patients treated with EndoAnchors betweenJune 2015 and May 2018 at our institution. EndoAnchors were applied during the initialendovascular aneurysm repair procedure (primary implant) to prevent proximal neckcomplications in difficult anatomies (nine patients), and in the follow-up afteraneurysm exclusion (secondary implant) to correct type Ia endoleak and/or stent-graftmigration (eight patients).ResultsMean time for anchors implant was 23 min (range 12–41), with a mean of 5 EndoAnchorsdeployed per patient. Six patients in the secondary implant group required a proximalcuff due to stent-graft migration ≥10 mm. Technical success was achieved in all cases,with no complications related to deployment of the anchors. At a median follow-up of 13months (range 4–39, interquartile range 9–20), there were no aneurysm-related deaths oraneurysm ruptures, and all patients were free from reinterventions. CT-scan surveillanceshowed no evidence of type Ia endoleak, anchors dislodgement or stent-graft migration,with a mean reduction of aneurysm diameter of 0.4 mm (range 0–19); there was no sacgrowth or aortic neck enlargement in any case.ConclusionsEndoAnchors can be safely used in the prevention and treatment of type Ia endoleaks inpatients with challenging aortic necks, with good results in terms of sac exclusion anddiameter reduction in the mid-term follow-up.