LONG-TERM COMPLICATIONS FOLLOWING ENDOVASCULAR REPAIR (EVAR) OF INFRARENAL ABDOMINAL AORTIC ANEURYSMS (AAA) USING ANACONDA™ STENT-GRAFT PROSTHESES f.meyer@med.ovgu.de

PE058

LONG-TERM COMPLICATIONS FOLLOWING ENDOVASCULAR REPAIR (EVAR) OF INFRARENAL ABDOMINAL AORTIC ANEURYSMS (AAA) USING ANACONDA™ STENT-GRAFT PROSTHESES

3

Germany

Poster Exhibition only

Objective: To determine long-term outcome of EVAR using Anaconda™ stent-graft prostheses

Single-center, retrospective observational study (design) of all consecutive patients who underwent EVAR with an Anaconda™ stent-graft at a tertiary center under routine clinical conditions (“real-world data”) during a defined study period

From 2008-2016, 60 Anaconda™ stent-grafts were implanted for infrarenal AAA (follow-up period: 15±2 years). The male-to-female ratio was 54:6 (9:1); mean age was 72.5 years. Twenty-seven endoleaks of any type occurred (45.0%). Incidence of type-I and type-II endoleaks was 8.3% (n=5) and 36.7% (n=22), respectively; no type-III or -IV endoleaks were observed. Pronounced graft migration occurred in five cases (8.3%). A markedly elevated rate of thromboembolic limb occlusions was documented (n=10; 16.7%). Late open surgical conversion was required in eight patients (13.3%) — four cases (6.7%) for recurrent embolic events and four individuals (6.7%) for stent-graft migration. When compared with two recent publications (Insernia et al., 2021; Abatzis-Papadopoulos et al., 2024), the authors reported noticeably higher rates of thromboembolic events and conversion to open surgical treatment.

The temporary clustering of stent-graft migrations following EVAR, observed within the first decade post-implantation, indicates a sustained upward trend in their incidence. Definitive treatment usually requires open vascular surgery, as dislocated grafts may present in grotesque configurations and positions. The elevated incidence of thromboembolic limb occlusions (as also described in the contemporary literature) supports the consideration of late open surgical conversion and an age-adapted decision-making process that may favor primary open aneurysm repair in selected patients.