Mid- to Long-Term Outcomes of Endovascular Aneurysm Repair Using the Ankura Stent Graft: An Eight-Year Single-Center Experience.

Background and Objectives: The Ankura stent graft was introduced in Europe in 2015 for the endovascular repair of infrarenal abdominal aortic aneurysms (AAAs). Evidence regarding its long-term efficacy remains limited. This study presents eight years of clinical experience with the Ankura endograft for endovascular aneurysm repair (EVAR) at a tertiary university vascular center. Materials and Methods: This single-center retrospective study included patients who underwent elective EVAR with the Ankura endograft between January 2015 and January 2023. All patients were anatomically suitable according to the instructions for use (IFU). Computed tomography angiography was performed at 1 and 12 months and annually thereafter during follow-up; the surveillance protocol was subsequently modified to use duplex ultrasound. Primary outcomes were categorized as early (technical success, clinical success, and 30-day mortality and morbidity) or late (aneurysm-related and non-aneurysm-related mortality). Results: A total of 220 patients were included (211 men [95.9%]); the mean age was 71.41 years (range, 49-87 years); and the mean aneurysm diameter was 59.15 mm (range, 32-109 mm). Primary and secondary technical success rates were 97.3% and 100%, respectively, and the clinical success rate was 96.8%. Thirty-day morbidity and mortality rates were 6.3% and 0%, respectively. No perioperative conversions occurred. The mean follow-up duration was 51.76 months (range, 1-131 months). Freedom from reintervention at 24, 36, 48, and 72 months was 98.2%, 97.7%, 97.2%, and 95.9%, respectively. Iliac limb patency was 99.5%. Aneurysm-related and non-aneurysm-related mortality during follow-up were 2.2% and 20.45%, respectively. Conclusions: In this study, the Ankura AAA stent graft demonstrated durable efficacy, with a high iliac limb patency rate, a low reintervention rate, and low aneurysm-related mortality during follow-up. Its long-term efficacy and safety should be evaluated in larger studies.