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. 2024 Sep 12;13(18):5413.
doi: 10.3390/jcm13185413.

Early and Mid-Term Results of Endovascular Aneurysm Repair with the Cordis Incraft Ultra-Low Profile Endograft: A High-Volume Center Experience

Luigi Baccani  1 , Gianbattista Parlani  1 , Giacomo Isernia  1 , Massimo Lenti  1 , Andrea Maria Terpin  1 , Gioele Simonte  1
Affiliations

Early and Mid-Term Results of Endovascular Aneurysm Repair with the Cordis Incraft Ultra-Low Profile Endograft: A High-Volume Center Experience

Luigi Baccani et al. J Clin Med. .

Abstract

Background/Objectives: In recent years, manufacturers have developed new low-profile stent grafts to allow endovascular treatment of abdominal aortic aneurysms (AAA) in patients with small access vessels. We evaluated the early and mid-term outcomes of the Incraft (Cordis Corp, Bridgewater, NJ, USA) ultra-low profile endograft implantation in a high-volume single center. Methods: Between 2014 and 2023, 133 consecutive endovascular aneurysm repair (EVAR) procedures performed using the Incraft endograft were recorded in a prospective database. Indications included infrarenal aortic aneurysms, common iliac aneurysms, and infrarenal penetrating aortic ulcers. Mid-term results were analyzed using the Kaplan-Meier method. Results: During the study period, 133 patients were treated with the Cordis Incraft endograft, in both elective and urgent settings. The Incraft graft was the first choice for patients with hostile iliac accesses, a feature characterizing at least one side in 90.2% of the patients in the study cohort. The immediate technical success rate was 78.2%. The intraoperative endoleak rate was 51.9% (20.3% type 1 A, 0.8% type 1 B, and 30.8% type 2 endoleak). Within 30 days, technical and clinical success rates were both 99.3%; all type 1A and 1B endoleaks were resolved at the 30-day follow-up CT-angiogram. After a mean follow-up of 35.4 months, the actuarial freedom from the re-intervention rate was 96.0%, 91.1%, and 84.0% at 1, 3, and 5 years, respectively. The iliac leg patency rate was 97.1%, 94.1%, and 93.1% at 1, 3, and 5 years, respectively. No statistically significant differences were observed between hostile and non-hostile access groups, nor between the groups with grade 1, grade 2, and grade 3 access hostility. Conclusions: The ultra-low profile Cordis Incraft endograft represents a valid option for the endovascular treatment of AAA in patients with hostile iliac accesses. The procedure can be performed with high rates of technical and clinical success at 30 days and the rates of iliac branch occlusion observed during the follow-up period appear acceptable in patients with poor aorto-iliac outflow.

Keywords: EVAR; endograft; endovascular aortic repair; hostile access; low profile.

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Conflict of interest statement

GP, GI, and GS are consultants for Cordis. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Five years overall survival estimate calculated by the Kaplan–Meier method.
Figure 2
Figure 2
Five years of freedom from any reintervention calculated by the Kaplan–Meier method.
Figure 3
Figure 3
Five years of freedom from open surgical conversion calculated by the Kaplan–Meier method.
Figure 4
Figure 4
Five years of freedom from iliac leg occlusion calculated by the Kaplan–Meier method.
Figure 5
Figure 5
Five years of freedom from iliac leg occlusion in hostile (red) and non-hostile (blue) anatomy calculated by the Kaplan–Meier method.
Figure 6
Figure 6
Five years of freedom from iliac leg occlusion in grade 1 (blue), grade 2 (red), and grade 3 (green) hostile anatomy were calculated by the Kaplan–Meier method.
Figure 7
Figure 7
Pre-operative CT-angiogram of a patient with AAA and chronic total occlusion of the right common iliac artery (A); final intraoperative angiography and post-operative CT-angiogram demonstrating effective Incraft implantation with sac exclusion and complete right common iliac artery recanalization (B,C).
See this image and copyright information in PMC

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