Performance of the Aorfix endograft in severely angulated proximal necks in the PYTHAGORAS United States clinical trial

Journal of Vascular Surgery
Mahmoud B MalasMark Fillinger

Abstract

This study compared the performance of the Aorfix endograft (Lombard Medical, Oxfordshire, United Kingdom) in standard (<60°), highly angled (60°-90°), and severely angled (>90°) aortic necks in the PYTHAGORAS study and evaluated changes in neck morphology over time. PYTHAGORAS is a prospective nonrandomized clinical trial of the Aorfix endograft. We divided the endovascular aneurysm repair (EVAR) cohort into groups by standard, high, and severe neck angle. The primary control group was patients concurrently undergoing open repair. Mortality at 30 days, 1 year, and 2 years and 30-day freedom from Society for Vascular Surgery major adverse events for the EVAR groups was compared with the open control. Aneurysm sac change, type I and III endoleaks, graft migration, and the reintervention rate at 1 and 2 years was compared between the standard, highly, and severely angled populations. The relative risk of graft complications with a neck diameter increase >10% was also calculated. At predetermined anatomic points, the effect of oversizing on aortic diameter was evaluated by calculating oversize percentage ([1 - outer aortic diameter measured at a given time/stent graft diameter] × 100%) preoperatively and at 3 years. In addition, t...Continue Reading

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Citations

Mar 10, 2016·Expert Review of Medical Devices·Benjamin ColvardLee Swanstrom
Nov 9, 2016·Seminars in Vascular Surgery·Matthew R Smeds, Kristofer M Charlton-Ouw
Jul 5, 2016·Current Treatment Options in Cardiovascular Medicine·John E O'Mara, Robert M Bersin
Aug 28, 2016·British Journal of Anaesthesia·S W K Cheng
Jan 22, 2017·La Radiologia medica·Nikolaos SchoretsanitisGeorge S Georgiadis
Apr 22, 2017·Interactive Cardiovascular and Thoracic Surgery·Miltiadis I MatsagkasAthanasios Giannoukas
Nov 19, 2019·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Maaike A KoenradesRobert H Geelkerken
Aug 21, 2019·Vascular and Endovascular Surgery·Satinderjit LochamMahmoud B Malas
Aug 15, 2018·Der Radiologe·A MaßmannA Bücker
Mar 25, 2021·Seminars in Vascular Surgery·Christina L Marcaccio, Marc L Schermerhorn

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