Comparison of midterm results for the Talent and Endurant stent graft

Yannick W. ‘t Mannetje, Philippe W.M. Cuypers, Ben R. Saleem, Aron S. Bode, Joep A.W. Teijink, Marc R.H.M. van Sambeek

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Objective Stent graft evolution is often addressed as a cause for improved outcomes of endovascular aneurysm repair for patients with an abdominal aortic aneurysm. In this study, we directly compared the midterm result of Endurant stent graft with its predecessor, the Talent stent graft (both Medtronic, Santa Rosa, Calif). Methods Patient treated from January 2005 to December 2010 in a single tertiary center in The Netherlands with a Talent or Endurant stent graft were eligible for inclusion. Ruptured abdominal aortic aneurysms or patients with previous aortic surgery were excluded. The primary end point was the Kaplan-Meier estimated freedom from secondary interventions. Secondary end points were perioperative outcomes and indications for secondary interventions. Results In total, 221 patients were included (131 Endurant and 90 Talent). At baseline, the median aortic bifurcation was narrower for the Endurant (30 mm vs 39 mm; P <.001). Median follow-up was 64.1 ± 37.9 months and 59.2 ± 25.3 months for Talent and Endurant, respectively. The estimated freedom from secondary interventions at 30 days, 1 year, 5 years, and 7 years was 94.3%, 89.4%, 72.2%, and 64.1% for Talent and 96.8%, 89.3%, 75.2%, and 69.2% for Endurant (P =.528). The indication for secondary interventions does differ; more patients required an intervention for a proximal neck-related complication (type Ia endoleak or migration) in the Talent group (18.2% vs 4.8%; P =.001), whereas more interventions for iliac limb stenosis were seen in the Endurant group (0.0% vs 4.8%; P =.044). In a binomial regression analysis, suprarenal angulation, infrarenal neck length, and type of stent graft were independent predictors of neck-related complications. Conclusions Evolution from the Talent stent graft into the Endurant has resulted in significant reduction of infrarenal neck-related complications; on the other hand, iliac interventions increased. The overall midterm secondary intervention rate was comparable.

Original languageEnglish
Pages (from-to)735-742
Number of pages8
JournalJournal of Vascular Surgery
Volume66
Issue number3
DOIs
Publication statusPublished - 1 Sep 2017

Keywords

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal/diagnostic imaging
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation/adverse effects
  • Chi-Square Distribution
  • Disease-Free Survival
  • Endovascular Procedures/adverse effects
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands
  • Postoperative Complications/etiology
  • Prosthesis Design
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Tertiary Care Centers
  • Time Factors
  • Treatment Outcome

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