One-year results of the ANCHOR trial of EndoAnchors for the prevention and treatment of aortic neck complications after endovascular aneurysm repair

Vascular. 2016 Apr;24(2):177-86. doi: 10.1177/1708538115590727. Epub 2015 Jun 10.

Abstract

Objectives: EndoAnchors have been used to address proximal aortic neck complications including type Ia endoleaks and endograft migration after endovascular aortic aneurysm repair (EVAR).

Methods: The study population included 100 patients with one-year follow-up in the ANCHOR study. A primary cohort (N = 73) comprised patients who underwent EndoAnchor implantation at the time of an initial EVAR and a Revision cohort (N = 27) included patients treated remote from EVAR. A hostile neck was defined for neck length <10 mm, neck diameter >28 mm, angulation >60°, conical configuration or significant mural thrombus or calcium.

Results: Baseline anatomy included neck length of 17 ± 14 mm, diameter of 27 ± 5 mm, and angulation of 35 ± 18°; 83% of patients had hostile necks. Over 18 ± 4 months of clinical follow-up, six patients (6%) underwent aneurysm-related reinterventions. There were no aneurysm ruptures. Over 13 ± 2 months of imaging follow-up, freedom from type Ia endoleak was 95% in the Primary Arm and 77% in the Revision Arm (P = .006). Aneurysm sacs regressed > 5 mm within one year in 45% of the Primary cases and in 25% of the Revisions. Aneurysm expansion > 5 mm occurred in one revision patient.

Conclusion: Despite a high frequency of hostile neck anatomy, proximal neck complications were relatively infrequent after EndoAnchor use.

Keywords: Aneurysm; EndoAnchors; Type Ia endoleak; aorta; endovascular; migration.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endoleak / diagnostic imaging
  • Endoleak / etiology
  • Endoleak / prevention & control*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Europe
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology
  • Foreign-Body Migration / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Risk Factors
  • Stents*
  • Suture Anchors
  • Suture Techniques / adverse effects
  • Suture Techniques / instrumentation*
  • Time Factors
  • Treatment Outcome
  • United States