Nellix: New possibilities in the treatment of the aorto-iliac aneurysm - our initial experiences

Abstract

The Endologix developed an aortoiliac stent graft system that is different than the conventional implantation technique (Nellix, EVAS-endovascular aneurysm sealing system). The first implantation in Hungary has been performed in the beginning of 2016 at Heart and Vascular Center. Nellix: two endobags surrounding ballon-expandable covered stent (10 mm) with optional length, biocompatible polymer which is able to be injected into the endobags and a procedure-coordinating console. The instructions for use: aortic neck length: ≥10 mm, neck diameter: 18-32 mm, angulation: ≤60°, blood lumen diameter: ≤60 mm, aneurysm maximal diameter: >50 mm, common iliac artery (CIA) minimal and maximal diameter: ≥9 mm, ≤35 mm. Six elective implantations were performed at our clinic. The average age of the patients were: 68.33 ± 12.44 year, the rate of male was 100%. The reason of implantations was isolated infrarenal aortic aneurysm, CIA aneurysm or both. The average postoperative in-hospital stay were 5.17 ± 1.47 days. In the perioperative period fever and femoral wound healing problem developed in one patient respectively. The average follow-up period were 177.17 ± 96.91 days. There was no endoleak, graft-migration, aneurysm growth, reoperation or death. A stroke with left hemiparesis without residual symptoms developed in one case in the third week after the operation. Due to the new EVAS technology, according to 30-day and midterm results the system is able to be used in complicated anatomical situations with low perioperative mortality and morbidity, and it can decrease the incidence of endoleaks, graftmigration and aneurysm growth.