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Midterm Aortic Neck Evolution after EndoSuture Aneurysm Repair: a Single Centre Retrospective Analysis
Raffaele Pio Ammollo1, Nicolas Mauchien1, Alexandre Oliny1,2
1Department of Vascular and Endovascular Surgery, Hospices Civils de Lyon, Louis Pradel University Hospital, Bron, France.
EJVES Vascular Forum
|October 29, 2025
Summary
EndoSuture aneurysm repair (ESAR) shows no aortic neck dilation at midterm follow-up, preventing type 1 endoleaks. This aortic repair method is feasible for patients with hostile aortic necks or anatomical constraints for other procedures.
Area of Science:
- Vascular Surgery
- Endovascular Aneurysm Repair
- Aortic Aneurysm Treatment
Background:
- Long-term data suggest EndoSuture aneurysm repair (ESAR) is effective for preventing type 1 endoleaks (EL1a) and promoting sac shrinkage in patients with hostile aortic necks.
- However, limited information exists regarding the midterm behavior of the aortic neck following ESAR.
Purpose of the Study:
- To retrospectively analyze the midterm evolution of the aortic neck after ESAR.
- To evaluate the overall outcomes of ESAR procedures in patients with hostile aortic necks or contraindications for other repair methods.
Main Methods:
- Retrospective analysis of ESAR procedures performed between September 2017 and August 2020.
- Inclusion criteria: patients with hostile aortic necks, unsuitability for open repair, or anatomical/technical limitations for fenestrated endovascular aneurysm repair (FEVAR).
- Follow-up duration: 36.5 ± 16.3 months.
Main Results:
- Twenty-three patients (96% male, median age 75) underwent ESAR.
- 100% technical success and 96% procedural success.
- No peri-operative aortic rupture or dissection.
- No aortic neck dilation observed at 6, 12, 24, and 36 months.
- No persistent or new type 1 endoleaks (EL1a) or limb occlusions.
- 0% 30-day and 1-year mortality.
- Overall survival at 1, 2, and 3 years was 100%, 100%, and 74%, respectively.
Conclusions:
- ESAR may prevent midterm aortic neck and suprarenal aortic dilatation.
- EndoAnchors used in ESAR appear to stabilize the aortic neck.
- ESAR is a viable option for complex aortic aneurysm cases unsuitable for FEVAR or open repair.
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