Anatomical Feasibility of an Off-the-shelf Scalloped Stent-graft for Infrarenal Abdominal Aneurysm With a Hostile Neck

NCT05150873 | Completed

• 1 other identifier: 3499
• Study Type: observational
• Target: 1,000
• Locations: 1 country
• Sites: 1

Brief Summary

In clinical practice a lot of EVAR cases are performed IFU for adverse neck anatomy(6) with acceptable short- and mid-term outcomes, but the long-term durability is currently an issue (7). Neck length shorter than 15 mm and angulation are two of. neck charteristics. that contribute more to define an "hostile neck" (8). The issue linked to the anatomical not feasibility of standard EVAR in patients not eligible for OR can be solved with custom made devices (CMD), but they were limited by high production costs and long time for creations (10-12 weeks)1. Nowadays no one off-the-shelf device aimed to overcome neck hostility in AAA is available on the market. The present study aims at evaluating the anatomical applicability of an off-the-shelf scalloped stent-graft to treat infrarenal AAA with a short and/or angulated neck.

Conditions

Aortic Aneurysm

Keywords

EVAR; AAA; Off-the-shelf

Outcome Measures

Primary Outcomes (1)

• Anatomica feasibility and applicability of an "off-the-shelf" scallopped stent-graft measured mesured fitting three device model with data recorded from CTA of patients with AAA treted in our unit

  observational study on the anatomical applicability in the coordinator center of an off-the-shelf scalloped device to treat infrarenal AAA with short and/or angulated neck. 3 different endograft designs were constructed. The preoperative measurements were made according to a previously described methodology. The models were matched with each preoperative CTA measure in order to evaluate if they fit or not in the index patients.

  6-months

Study Arms (1)

Patients ttreatted for AAA

Patients affected by AAA and treated att our institution with EVAR and/or Open Repair between 2010 and 2020

Other: CTA evaluation

Interventions

CTA evaluation OTHER

Any pre-operattive CTA of the patients of the cohort will be carefully evaluated to determine the theoric anatomical feasibility of an off the shelf Endograft, particularly in patients with an angulated and short aortic neck

Patients ttreatted for AAA

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients affected by AAAs and electively treated with EVAR or OR in the Vascular Surgery Unit of Modena e Reggio Emilia from 2010 to 2020 were considered eligible for the ex-vivo feasibility study. Mandatory condittion for tthhe enrollemnt is an available 2.5mm CTA.

You may qualify if:

• Patients Electively treated with EVAR or AAA at the coordinator center
• Age \>18
• Both sex
• Preoperative 2.5mm CTA available
• Written informed consent.

Sponsors & Collaborators

• Azienda Ospedaliero-Universitaria di Modena: lead

Study Sites (1)

AOU di Modena, OCB

Baggiovara, Modena, 411266, Italy

Location

Related Publications (10)

• Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, Dick F, van Herwaarden J, Karkos C, Koelemay M, Kolbel T, Loftus I, Mani K, Melissano G, Powell J, Szeberin Z, Esvs Guidelines Committee, de Borst GJ, Chakfe N, Debus S, Hinchliffe R, Kakkos S, Koncar I, Kolh P, Lindholt JS, de Vega M, Vermassen F, Document Reviewers, Bjorck M, Cheng S, Dalman R, Davidovic L, Donas K, Earnshaw J, Eckstein HH, Golledge J, Haulon S, Mastracci T, Naylor R, Ricco JB, Verhagen H. Editor's Choice - European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019 Jan;57(1):8-93. doi: 10.1016/j.ejvs.2018.09.020. Epub 2018 Dec 5. No abstract available.

  PMID: 30528142 BACKGROUND

• Gimenez-Gaibar A, Gonzalez-Canas E, Solanich-Valldaura T, Herranz-Pinilla C, Rioja-Artal S, Ferraz-Huguet E. Could Preoperative Neck Anatomy Influence Follow-up of EVAR? Ann Vasc Surg. 2017 Aug;43:127-133. doi: 10.1016/j.avsg.2016.12.011. Epub 2017 Apr 6.

  PMID: 28390913 BACKGROUND

• Caradu C, Berard X, Midy D, Ducasse E. Influence of Anatomic Angulations in Chimney and Fenestrated Endovascular Aneurysm Repair. Ann Vasc Surg. 2017 Aug;43:104-114. doi: 10.1016/j.avsg.2017.01.002. Epub 2017 Feb 28.

  PMID: 28258015 BACKGROUND

• Speziale F, Sirignano P, Setacci F, Menna D, Capoccia L, Mansour W, Galzerano G, Setacci C. Immediate and two-year outcomes after EVAR in "on-label" and "off-label" neck anatomies using different commercially available devices. analysis of the experience of two Italian vascular centers. Ann Vasc Surg. 2014 Nov;28(8):1892-900. doi: 10.1016/j.avsg.2014.06.057. Epub 2014 Jul 7.

  PMID: 25011083 BACKGROUND

• Muhs BE, Jordan W, Ouriel K, Rajaee S, de Vries JP. Matched cohort comparison of endovascular abdominal aortic aneurysm repair with and without EndoAnchors. J Vasc Surg. 2018 Jun;67(6):1699-1707. doi: 10.1016/j.jvs.2017.10.059. Epub 2017 Dec 18.

  PMID: 29248241 BACKGROUND

• AbuRahma AF, DerDerian T, AbuRahma ZT, Hass SM, Yacoub M, Dean LS, Abu-Halimah S, Mousa AY. Comparative study of clinical outcome of endovascular aortic aneurysms repair in large diameter aortic necks (>31 mm) versus smaller necks. J Vasc Surg. 2018 Nov;68(5):1345-1353.e1. doi: 10.1016/j.jvs.2018.02.037. Epub 2018 May 22.

  PMID: 29802043 BACKGROUND

• Chaikof EL, Fillinger MF, Matsumura JS, Rutherford RB, White GH, Blankensteijn JD, Bernhard VM, Harris PL, Kent KC, May J, Veith FJ, Zarins CK. Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg. 2002 May;35(5):1061-6. doi: 10.1067/mva.2002.123991. No abstract available.

  PMID: 12021728 BACKGROUND

• Marone EM, Freyrie A, Ruotolo C, Michelagnoli S, Antonello M, Speziale F, Veroux P, Gargiulo M, Gaggiano A. Expert Opinion on Hostile Neck Definition in Endovascular Treatment of Abdominal Aortic Aneurysms (a Delphi Consensus). Ann Vasc Surg. 2020 Jan;62:173-182. doi: 10.1016/j.avsg.2019.05.049. Epub 2019 Aug 6.

  PMID: 31394211 BACKGROUND

• Gallitto E, Faggioli G, Spath P, Pini R, Mascoli C, Ancetti S, Stella A, Abualhin M, Gargiulo M. The risk of aneurysm rupture and target visceral vessel occlusion during the lead period of custom-made fenestrated/branched endograft. J Vasc Surg. 2020 Jul;72(1):16-24. doi: 10.1016/j.jvs.2019.08.273. Epub 2020 Feb 13.

  PMID: 32063442 BACKGROUND

• Chaikof EL, Dalman RL, Eskandari MK, Jackson BM, Lee WA, Mansour MA, Mastracci TM, Mell M, Murad MH, Nguyen LL, Oderich GS, Patel MS, Schermerhorn ML, Starnes BW. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018 Jan;67(1):2-77.e2. doi: 10.1016/j.jvs.2017.10.044.

  PMID: 29268916 RESULT

MeSH Terms

Conditions

Aortic Aneurysm

Condition Hierarchy (Ancestors)

Aneurysm; Vascular Diseases; Cardiovascular Diseases; Aortic Diseases

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor in Vascular Surgery, Chief of department

Study Record Dates

• First Submitted: November 25, 2021
• First Posted: December 9, 2021
• Study Start: January 1, 2022
• Primary Completion: June 1, 2022
• Study Completion: December 1, 2022
• Last Updated: February 6, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)