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Endovascular Repair of a Failed Nellix Endograft Proximal Sealing Zone Using the Altura Stent-Graft: A Case Report and Literature Review

Endovascular aortic aneurysm sealing (EVAS) with the Nellix endograft was initially considered a groundbreaking and acceptable alternative to conventional endovascular aortic aneurysm repair, with encouraging initial results. However, long-term follow-up has revealed a high incidence of endograft-re...

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Detalles Bibliográficos
Autores principales: Chatzelas, Dimitrios A., Pitoulias, Apostolos G., Tsamourlidis, Georgios V., Zampaka, Theodosia N., Potouridis, Anastasios G., Tachtsi, Maria D., Pitoulias, Georgios A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Vascular Surgery 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10694563/
https://www.ncbi.nlm.nih.gov/pubmed/38044693
http://dx.doi.org/10.5758/vsi.230076
Descripción
Sumario:Endovascular aortic aneurysm sealing (EVAS) with the Nellix endograft was initially considered a groundbreaking and acceptable alternative to conventional endovascular aortic aneurysm repair, with encouraging initial results. However, long-term follow-up has revealed a high incidence of endograft-related complications, such as caudal migration and type Ia endoleaks, indicating the need for reintervention. Managing failed EVAS remains challenging and is an ongoing topic of discussion, especially for high-risk patients. We describe a 70-year-old female who initially underwent EVAS with a Nellix endograft and presented after 5 years of follow-up with caudal endograft migration and a type Ia endoleak. The patient was treated with endovascular implantation of an Altura stent-graft, a relatively new low-profile device with a similar double stent configuration. Device migration and endoleaks were undetectable at 12 months of follow-up, suggesting that the Altura might offer a safe and efficient approach in cases of Nellix proximal failure.