Hybrid endograft solution for complex iliac anatomy: Zenith body and Excluder limbs

The purpose of this study was to evaluate single-center results with selective use of Gore Excluder limbs (W.L. Gore & Associates, Flagstaff, AZ) in a Cook Zenith body (Cook Inc, Bloomington, IN) for elective endovascular abdominal aortic aneurysm (AAA) repair. A prospectively held database for patients with AAA, who were treated endovascularly between March 1999 and July 2008, was queried for patients treated with a Cook Zenith body and one or two Gore Excluder limbs. Indication, technical success, late limb occlusion, and disconnection were evaluated. From 276 patients who were treated with a Zenith body, 29 underwent repair with hybrid graft components with, in total, 41 Gore Excluder limbs. The indication was always complex iliac anatomy. The primary technical success rate in this group was 89% (26 of 29 patients), with a primary assisted technical success rate of 100%. Mortality at 30 days was 0%. The mean follow-up was 19.4 months (range 2-64 months). Late mortality was 13.8% (4 of 29), with no aneurysm-related death. No graft limb occlusion or disconnection occurred during follow-up. No reintervention was needed in the hybrid endograft group. The use of a Cook Zenith body with Gore Excluder limb(s) in case of adverse iliac anatomy is feasible and showed no adverse effects at the midterm follow-up.