Abstract
ObjectiveWe describe our initial experience with the use of the TriVascular Ovation endograft system for the treatment of abdominal aortic aneurysms (AAA).MethodsWe retrospectively reviewed data from patients treated for AAA using the Ovation endograft at two institutions from January 2011 to September 2012. Main outcomes included primary success, survival, complications, and device-related events. The mean follow-up period was 10 months (range 1–22 months).ResultsThirty-seven patients (male: 95%, mean age: 76 yr) were treated for AAA (mean diameter: 54 mm) with the Ovation endograft. Local or regional anesthesia was used in 86.5% of cases. Percutaneous access was utilized in 73% of cases. Primary success was 89.2% (33/37). Four adjunctive procedures were required including two distal extensions (type 1b endoleak and iliac limb disconnection resulting in type III endoleak) and two bypass surgeries (limb graft occlusion and gate cannulation failure). No deaths or major complications were reported during the procedure or in follow-up. No type I, III, or IV endoleak, AAA enlargement, AAA rupture, stent fracture, migration, or endovascular or surgical reintervention were reported during the follow-up period. Type II endoleak was observed in two patients. Asymptomatic narrowing of both iliac limbs was observed in one patient at 6 months.ConclusionsOur initial experience with the Ovation endograft demonstrated encouraging results in patients with AAA.
Highlights
The first endovascular repair of an abdominal aortic aneurysm (AAA) was performed in 1990 by Dr Parodi [1], who implanted a large straight endograft into the abdominal aorta
The latest generation of ultra-low profile endografts currently allows the treatment of AAAs in patients who have previously been excluded because of challenging aortic anatomies and small access vessels
Patients We retrospectively reviewed data of all patients who were treated for AAA using the Ovation endograft system from January 2011 to September 2012 in our two centres
Summary
The first endovascular repair of an abdominal aortic aneurysm (AAA) was performed in 1990 by Dr Parodi [1], who implanted a large straight endograft into the abdominal aorta. Limitations of the use of a similar device soon became evident and new self-expandable materials and bifurcated stent-grafts, which had a smaller caliber than previous generations, rapidly became available. The latest generation of ultra-low profile endografts currently allows the treatment of AAAs in patients who have previously been excluded because of challenging aortic anatomies and small access vessels. Some have expressed concern that reducing the profile of a stent graft may compromise sealing. The search for an endograft with a smaller profile with no compromise on performance and durability of the device remains a therapeutic challenge. After having received the CE Mark on September 17th 2010, the low-profile TriVascular Ovation system (14 F) has been recently introduced to our institutions for use in selected patients with relatively challenging necks or smaller iliac vessels. The purpose of this study was to retrospectively review our early experience with this novel stent graft
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