Single-center experience using Endologix anatomically fixated endograft device for treatment of aortoiliac occlusive disease.

OBJECTIVE

The covered endovascular reconstruction of the aortic bifurcation (CERAB) technique was developed in recent years as a novel surgical intervention for aortoiliac occlusive disease (AIOD). One tool frequently used in such procedures is the anatomically fixated endograft (AFX), manufactured by Endologix. The present study aimed to review the outcomes of patients with AIOD after CERAB procedure using the Endologix AFX device.

METHODS

This is an institutional review board-approved retrospective study investigating the experience of a single center in using Endologix's AFX device as CERAB for AIOD from September 2018 to June 2024. Data were obtained from the medical records of all patients who underwent the CERAB procedure with the Endologix device during the designated time frame. The primary outcomes included 30-day mortality and postoperative complications. Secondary outcomes included changes in ABI and need for reintervention.

RESULTS

We identified 24 patients as having undergone CERAB in the period September 2018 to June 2024. The average age of the patients was 71.29 ± 7.56 years. The average length of procedure was 3 hours 30 minutes ± 0.09 hours. The median estimated blood loss for CERAB was 127.5 mL (interquartile range, 50-300 mL). The median postoperative length of stay for CERAB was 2.5 days (range, 1-56 days). Ten patients experienced postoperative complications (41.67%) overall, which included respiratory failure (16.67%), acute renal insufficiency (8.33%), hematoma (8.33%), and infection (8.33%). Four cases required reintervention (16.7%), and mortality within 30 days of procedure was 4.17% (n = 1). Postoperatively, 83.33% of evaluated patients experienced improved ABIs. The average change in the ankle-brachial index was 0.20 ± 0.27 on the right and 0.16 ± 0.22on the left.

CONCLUSIONS

Overall, the CERAB procedure using the AFX device from Endologix demonstrated a high technical success rate and low rate of postoperative complications and mortality. The short-term results suggest that the use of AFX in CERAB is an effective and relatively safe treatment option for patients with AIOD.