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Side-by-side deployment of gore excluder legs at a narrow terminal aorta for endovascular aneurysm repair

  • Original Article
  • Blood Vessel Prosthesis
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Abstract

Purpose

A narrow terminal aorta is a risk factor for endograft occlusion after endovascular aneurysm repair. To minimize limb complications, we used Gore Excluder legs positioned side-by-side at the terminal aorta. We investigated the outcomes of our strategy for endovascular aneurysm repair in patients with a narrow terminal aorta.

Methods

We enrolled 61 patients who underwent endovascular aneurysm repair with a narrow terminal aorta (defined as < 18 mm in diameter) from April 2013 to October 2021. The standard procedure involves complete treatment with the Gore Excluder device. When other types of main body endografts were used, they were deployed proximal to the terminal aorta, and we used the Gore Excluder leg device in the bilateral limbs. Postoperatively, the intraluminal diameter of the legs at the terminal aorta was measured to assess the configuration.

Results

During the follow-up period (mean: 2.7 ± 2.0 years), there were no aorta-related deaths, endograft occlusions, or leg-related re-interventions. There were no significant differences between the pre- and postoperative ankle-brachial pressure index values in the dominant and non-dominant legs (p = 0.44 and p = 0.17, respectively). Postoperatively, the mean difference rate (defined as [dominant leg diameter–non-dominant leg diameter]/terminal aorta diameter) was 7.5 ± 7.1%. The difference rate was not significantly correlated with the terminal aortic diameter, calcification thickness, or circumferential calcification (r = 0.16, p = 0.22; r = 0.07, p = 0.59; and r = − 0.07, p = 0.61, respectively).

Conclusions

Side-by-side deployment of Gore Excluder legs produces acceptable outcomes for endovascular aneurysm repair with a narrow terminal aorta. The endograft expansion at the terminal aorta is tolerable without influencing calcification distribution.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan

    Yu Hohri, Hidetake Kawajiri, Keiichi Kanda, Satoshi Numata, Takuma Kobayashi, Rie Nakai & Hitoshi Yaku

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  1. Yu Hohri
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  2. Hidetake Kawajiri
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  3. Keiichi Kanda
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  4. Satoshi Numata
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  5. Takuma Kobayashi
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  6. Rie Nakai
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  7. Hitoshi Yaku
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by YH, HK, TK and SN. The first draft of the manuscript was written by YH and RN. The critical revision of the manuscript was performed by HK and KK. The overall responsibility of the project was taken up by HY. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yu Hohri or Hidetake Kawajiri.

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Hohri, Y., Kawajiri, H., Kanda, K. et al. Side-by-side deployment of gore excluder legs at a narrow terminal aorta for endovascular aneurysm repair. J Artif Organs (2023). https://doi.org/10.1007/s10047-023-01406-y

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