EVAR procedure
All EVAR procedures were performed in a hybrid operating room by a
specific team of cardiovascular surgery. The unibody endografts have
been mainly used in the early period of the study. Afterwards, modular
endografts have taken place for our practice in recent years. The
devices used in this study were Ankura™ AAA (Lifetech) in 89 patients
(40.1%), AFX® (Endologix) in 68 patients (30.6%),
Endurant™II (Medtronic) in 58 patients (26.1%), Gore®Excluder® (Gore) in five patients (2.3%) and E-vita
Abdominal XT (Jotec) in two patients (0.9%).
Procedures performed in the hybrid room under general (169 patients,
76.1%) or loco-regional anesthesia (53 patients, 23.9%), based upon
surgical team, anesthesiologist and patient preference. Modular
endografts were deployed with standard fashions and the technique for
unibody endograft deployment has been previously
described.6 The Endologix AFX®device (unibody) consists of a main bifurcated unibody and a proximal
aortic extension. This endograft is the only graft with anatomical
fixation at the aortic bifurcation. The aortic extension is placed at
the infrarenal position. Completion angiography was performed after the
procedure. Type 1 endoleaks were treated by balloon angioplasty and
placement of extension cuff if needed. Type 2 endoleaks were followed.