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Today, EVAR is an effective and efficient treatment for abdominal aortic aneurysm.
However, there are certain endovascular aneurysm repair (EVAR) patients who are at greater risk for neck dilatation and/or loss of proximal seal, leading to worse outcomes.
Retrospective analysis of 552 elective EVARs5
Meta-analysis6 of neck diameters ≥ 25, ≥ 28, and ≥ 30 mm
Short
Wide
Angulated
Conical
AAA is a progressive dilating disease even after EVAR or open surgical repair.7
22% of EVAR patients were lost to imaging follow-up at 1 year.8 Independent risk factors for not following up:
Neck diameter is an independent risk factor for neck dilatation.10 Diameters ≥ 25 mm have greater risk of dilatation after EVAR
(p = 0.02).11
Wide necks are more likely to develop Type Ia endoleaks (p = 0.049),12 which transmit the highest pressures into the sac.13
Learn how ESAR with the Heli-FX EndoAnchor system reinforces the proximal seal and protects against neck dilatation to minimize both transient and persistent Type Ia endoleaks.
Learn about the benefits of ESAR and the key elements of deployment.
Learn from the experts about the clinical utility of ESAR as a solution for wide neck patients.
ESAR with the Heli-FX EndoAnchor system is your defense for patients at risk for suboptimal outcomes.
View presentations and videos, and find other educational resources.
Discover EducationMelas N, Perdikides T, Saratzis A, Saratzis N, Kiskinis D, Deaton DH. Helical EndoStaples enhance endograft fixation in an experimental model using human cadaveric aortas. J Vasc Surg. June 2012;55(6):1726-33.
ANCHOR 4-year primary arm. 2019 data cut. Medtronic data on file.
Chaudhuri A, Kim HK, Valdivia AR. Improved Midterm Outcomes Using Standard Devices and EndoAnchors for Endovascular Repair of Abdominal Aortic Aneurysms with Hyperangulated Necks [published online ahead of print, 2020May 8]. Cardiovasc Intervent Radiol. 2020;10.1007/s00270-020-02488-4.
Morris AD, Preiss JE, Ogbuchi S, et al. Longer Patient Travel Times Associated with Decreased Follow-Up after Endovascular Aortic Aneurysm Repair (EVAR). Am Surg. August 1, 2017;83(8):e339-341.
Antoniou GA, Georgiadis GS, Antoniou SA, Kuhan G, Murray D. A meta-analysis of outcomes of endovascular abdominal aortic aneurysm repair in patients with hostile and friendly neck anatomy. J Vasc Surg. February 2013;57(2):527-38.
Kouvelos GN, Antoniou G, Spanos K, Giannoukas A, Matsagkas M. Endovascular aneurysm repair in patients with a wide proximal aortic neck: a systematic review and meta-analysis of comparative studies. J Cardiovasc Surg (Torino). April 2019;60(2):167-174.
Oberhuber A, Buecken M, Hoffmann M, Orend KH, Mühling BM. Comparison of aortic neck dilatation after open and endovascular repair of abdominal aortic aneurysm. J Vasc Surg. April 2012;55(4):929-34.
Schanzer A, Messina LM, Ghosh K, et al. Follow-up compliance after endovascular abdominal aortic aneurysm repair in Medicare beneficiaries. J Vasc Surg. January 2015;61(1):16-22.e1.
Morris AD, Preiss JE, Ogbuchi S, et al. Longer Patient Travel Times Associated with Decreased Follow-Up after Endovascular Aortic Aneurysm Repair (EVAR). Am Surg. August 1, 2017;83(8):e339-341.
Tassiopoulos AK, Monastiriotis S, Jordan WD, Muhs BE, Ouriel K, De Vries JP. Predictors of early aortic neck dilatation after endovascular aneurysm repair with EndoAnchors. J Vasc Surg. 2017;66(1):45-52.
Cao P, Verzini F, Parlani G, et al. Predictive factors and clinical consequences of proximal aortic neck dilatation in 230 patients undergoing abdominal aorta aneurysm repair with self-expandable stent-grafts. June 2003; 37(6):1200-5.
Oliviera NFG, Golcalves FB, Ultee K, et al. Patients with large neck diameter have a higher risk of type 1A endoleaks and aneurysm rupture after standard endovascular aneurysm repair. J Vasc Surg. March 2019;69(3)783-791.
Li J, Tian X, Wang Z, et al. Influence of endoleak positions on the pressure shielding ability of stent-graft after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA). Biomed Eng Online. 2016;15(Suppl 2): 135.
Schlösser FJV, de Vries JPPM, Chaudhuri A. Is it Time to Insert EndoAnchors into Routine EVAR? Eur J Vasc Endovasc Surg. April 2017;53(4):458-459.
Tassiopoulos AK, Monastiriotis S, Jordan WD, Muhs BE, Ouriel K, De Vries JP. Predictors of early aortic neck dilatation after endovascular aneurysm repair with EndoAnchors. J Vasc Surg. July 2017;66(1):45-52.
Muhs BE, Jordan W, Ouriel K, et al. Matched cohort comparison of endovascular abdominal aortic aneurysm repair with and without EndoAnchors. J Vasc Surg. June 2018;67(6):1699-1707.