IMR Press / RCM / Volume 22 / Issue 2 / DOI: 10.31083/j.rcm2202051
Open Access Original Research
Long-term results of endovascular intervention with unibody bifurcation endograft for elective abdominal aortic aneurysm management
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1 Department of Cardiovascular Surgery, Ankara City Hospital, 06800 Ankara, Turkey
2 Department of Cardiovascular Surgery, Kartal Kosuyolu Hospital, 34145 İstanbul, Turkey
3 Department of Cardiovascular Surgery, Gülhane Training and Research Hospital, Gülhane Faculty of Medicine, University of Health Sciences, 06010 Ankara, Turkey
4 Department of Cardiovascular Surgery, Erol Olçok Training and Research Hospital, Hitit University, 19030 Corum, Turkey
Rev. Cardiovasc. Med. 2021, 22(2), 453–459;
Submitted: 17 February 2021 | Revised: 2 April 2021 | Accepted: 6 April 2021 | Published: 30 June 2021

Unibody bifurcated endografts have the advantage of reducing the operative time, avoiding migration and iliac limb dislocation in patient with abdominal aortic aneurysm (AAA). We report our long-term experience in patients who underwent endovascular aortic repair (EVAR) due to infrarenal AAA with Endologix AFX® endograft system. Between January 2013–December 2018, 68 patients with infrarenal AAA had EVAR procedure with Endologix AFX® endograft system. Mean follow-up was 40.4 ± 19.5 months, and all patients had computed tomography periodically, with colored Doppler ultrasonography (CDUS) every six months. Mean age was 68.5 ± 7.1 years and, 63 (92.6%) patients were male. Early mortality, renal complications, stent-graft migration and cardiac complications were not seen in early post-operative period. There was no early mortality in the group and no conversion to open repair. In long-term follow-up 12 patients (17.6%) had endoleak (5 with type II, 7 with type III). Overall survival estimated by Kaplan-Meier analysis was 94.1% at 1 year, 85.2% at 2 years, 74.1% at 3 years and 54.0% at 5 years. Freedom from second intervention and conversion was 98.4% at 1 year, 95.3% at 2 years, 93.3% at 3 years and 87.4% at 5 years. Endologix AFX® endograft provides a fast, safe and effective endograft for the early period, therefore it seems more suitable for elderly and comorbid patients. This endograft has low reintervention rates however according to our results, aneurysms larger than 6 cm may have more sideway displacement possibility and by this way type III endoleak. Proper patient selection and sufficient overlap are the key issues. Close monitoring is mandatory at the follow-up period.

Abdominal aortic aneurysm
Endovascular procedures
Cumulative survival rate
Fig. 1.
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