低プロファイルAltura®エンドグラフトシステムと標準プロファイルステントグラフトの腹部大動脈瘤修復術における比較：症例対照研究

Background/Objectives: Endovascular aneurysm repair (EVAR) is currently the preferred method for treating abdominal aortic aneurysms (AAA) due to lower perioperative morbidity and mortality compared with open aortic repair (OAR). However, anatomical limitations such as narrow or tortuous iliac arteries may preclude EVAR. The low-profile Altura^® stent graft (LPSG) was designed to overcome these limitations. This study aimed to compare the outcomes of Altura^® low-profile endografts with standard-profile stent grafts (SPSGs) in AAA treatment. Methods: This single-center, retrospective, case-matched study included 30 patients treated with Altura^® LPSG and 30 matched controls who underwent SPSG implantation between July 2021 and February 2023. Demographic, anatomical, operative, and postoperative parameters were analyzed. Follow-up was performed at 3, 6, and 12 months using ultrasound and computed tomography angiography (CTA). Results: Patients in the LPSG group more frequently had narrow access vessels (<6 mm, 46.7% vs. 3.3%, p = 0.001). The mean procedure time was shorter in the LPSG group (80 vs. 90 min, p = 0.04), and hospital stay was reduced (3 vs. 4 days, p = 0.03). No 30-day mortality occurred in either group. At 12 months, no aneurysm rupture, graft infection, or aneurysm-related death was observed. The rate of secondary interventions was comparable between groups. Conclusions: The low-profile Altura^® stent graft provides a safe and effective option for AAA patients with narrow access vessels. Its bilateral parallel configuration and lack of gate cannulation simplify EVAR, shorten procedure time, and may be especially beneficial in emergency or anatomically challenging cases. Further prospective studies are warranted to confirm these findings.