Annals of vascular surgery · 2026
One Year Outcomes of Endovascular Aneurysm Repair with the Alto Stent Graft in the Hellenic Alto Registry.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Barbatis Alexandros, Spanos Konstantinos, Ioannou Christos, Kakkos Stavros, Georgiadis George S, Kouvelos Georgios, Kontopodis Nikolaos, Giannoukas Athanasios
Аннотация
BACKGROUND: The Alto endograft received CE Mark approval in August 2020 for endovascular repair of abdominal aortic aneurysms (AAAs), requiring a proximal aortic landing zone of only 7 mm below the inferior renal artery for sealing. This study presents early and 1-year outcomes from the Hellenic Alto Registry in patients treated for intact AAAs, either electively or urgently for symptomatic aneurysms.
METHODS: The Hellenic Registry is a multicenter prospective database including patients who underwent endovascular aneurysm repair with the Alto Abdominal Stent Graft System between 2021 and 2023. Preoperative and postoperative aneurysm characteristics were recorded. Outcomes included early (technical success, 30-day survival) and 1-year results (survival, reintervention, sac remodeling, and endoleak presence).
RESULTS: A total of 124 patients (96% male, mean age 72.1 ± 6, mean AAA diameter 59.8 ± 10 mm) were included; 94% were asymptomatic. Mean proximal neck diameter at 7 mm was 23 ± 3 mm, length 18 ± 9 mm, and angulation 28 ± 14°. Nineteen patients (15%) had neck length <10 mm, and 14 (11%) had an aortic bifurcation <20 mm. Fifty-eight (45%) had at least 1 external iliac artery <7 mm. Technical success was 98%; 2 patients required intraoperative conversion to an aorto-uni-iliac endograft with femorofemoral bypass. Six patients underwent limb relining. Mean procedure time was 129 ± 60 min, mean contrast volume was 130 ± 50 mL, and median radiation 27 ± 18 min. Mean hospital stay was 2.5 ± 1.5 days. No intraoperative high flow endoleaks were detected. No death of reintervention was reported at 30 days. The mean aneurysm sac diameter was 58 ± 11 mm and 53.6±8 mm at 30 days and 1 postoperative year (58% stable, 34% decreased), respectively. At 1-year follow-up, the survival rate was 99,2% [standard error (SE) 0,8%], 98,4% (SE 1,1%) and 98,4% (SE 1,1%) at 80, 120 and 365 days respectively; The freedom from reintervention rate was rate was 99,2% (SE 0,8%), 98,4% (SE 1,1%), 96,7% (SE 1,6%) and 95,9% (SE 1,8%) at 30, 60, 180 and 365 days respectively. Freedom from type I endoleak rate was 99,2% (0,8%), 98,4% (SE 1,1%) and 97,5% (SE 1,4%) at 30, 180 and 365 days respectively.
CONCLUSION: In real-world practice, the Alto stent graft demonstrated excellent technical and clinical success with low reintervention rates at 1 year, including a part of patients with challenging proximal and distal anatomy.
METHODS: The Hellenic Registry is a multicenter prospective database including patients who underwent endovascular aneurysm repair with the Alto Abdominal Stent Graft System between 2021 and 2023. Preoperative and postoperative aneurysm characteristics were recorded. Outcomes included early (technical success, 30-day survival) and 1-year results (survival, reintervention, sac remodeling, and endoleak presence).
RESULTS: A total of 124 patients (96% male, mean age 72.1 ± 6, mean AAA diameter 59.8 ± 10 mm) were included; 94% were asymptomatic. Mean proximal neck diameter at 7 mm was 23 ± 3 mm, length 18 ± 9 mm, and angulation 28 ± 14°. Nineteen patients (15%) had neck length <10 mm, and 14 (11%) had an aortic bifurcation <20 mm. Fifty-eight (45%) had at least 1 external iliac artery <7 mm. Technical success was 98%; 2 patients required intraoperative conversion to an aorto-uni-iliac endograft with femorofemoral bypass. Six patients underwent limb relining. Mean procedure time was 129 ± 60 min, mean contrast volume was 130 ± 50 mL, and median radiation 27 ± 18 min. Mean hospital stay was 2.5 ± 1.5 days. No intraoperative high flow endoleaks were detected. No death of reintervention was reported at 30 days. The mean aneurysm sac diameter was 58 ± 11 mm and 53.6±8 mm at 30 days and 1 postoperative year (58% stable, 34% decreased), respectively. At 1-year follow-up, the survival rate was 99,2% [standard error (SE) 0,8%], 98,4% (SE 1,1%) and 98,4% (SE 1,1%) at 80, 120 and 365 days respectively; The freedom from reintervention rate was rate was 99,2% (SE 0,8%), 98,4% (SE 1,1%), 96,7% (SE 1,6%) and 95,9% (SE 1,8%) at 30, 60, 180 and 365 days respectively. Freedom from type I endoleak rate was 99,2% (0,8%), 98,4% (SE 1,1%) and 97,5% (SE 1,4%) at 30, 180 and 365 days respectively.
CONCLUSION: In real-world practice, the Alto stent graft demonstrated excellent technical and clinical success with low reintervention rates at 1 year, including a part of patients with challenging proximal and distal anatomy.
Предметные рубрики MeSH
AgedAged, 80 and overFemaleHumansMaleAortic Aneurysm, AbdominalBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationDatabases, FactualEndoleakEndovascular Aneurysm RepairEndovascular ProceduresPostoperative ComplicationsProsthesis DesignRegistriesRisk AssessmentRisk FactorsStentsTime FactorsTreatment Outcome