The Nellix endovascular aneurysm sealing system: current perspectives.

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Abdominal Aortic Aneurysm Treatment

Background:

• The Nellix endovascular aneurysm sealing (EVAS) system offers a novel approach for treating abdominal aortic aneurysms (AAA).
• Evaluating the efficacy of EVAS in managing AAA patients is crucial for understanding its clinical utility.

Purpose of the Study:

• To assess the clinical outcomes and efficacy of the Nellix EVAS system in patients with asymptomatic, non-ruptured AAA.
• To identify and quantify the incidence of complications associated with EVAS treatment.

Main Methods:

• A systematic literature search was conducted across PubMed/MEDLINE, CINAHL, and reference lists.
• Pooled dichotomous outcome data from 14 single-arm observational studies involving 1,510 patients were analyzed using random-effects models.

Main Results:

• Technical success rate was high at 99%.
• Complications included type I endoleak (2.8% early, 1.9% late), sac enlargement (3.1%), device migration (2.1%), and aneurysm rupture (0.7% early, 0.8% late).
• 30-day mortality was 1.5%, and aneurysm-related death during follow-up was 1.0%.

Conclusions:

• EVAS demonstrates acceptable outcomes for AAA management.
• Type I endoleak, sac enlargement, device migration, and aneurysm rupture are identified complications requiring monitoring.
• Further high-level research is warranted to explore potential advantages of EVAS over conventional treatments.