Abdominal Aortic Aneurysm
Currently, there are two main options for repair of abdominal aortic aneurysms (AAA): open repair and endovascular repair. Since the early 2000s, Endovascular Repair of Aneurysm (EVAR) has become the mainstay for treatment of AAAs. As opposed to open repair, EVAR is a minimally invasive procedure that involves placement of a large covered stent (stent-graft) via the large arteries in the groins.
The advantages of EVAR over open repair are vast and include significantly less pain, length of hospital stay, and blood loss. Since its inception, stent-graft technology has markedly improved. The first endovascular repairs in the early 1990s were performed with insertion of Dacron (polyester fiber) fixed stainless-steel stents. Since that time, advances in technology and changes in prosthetic material have allowed for development of stent-grafts that are more durable, fatigue resistant, conformable, and easily-deployed.
Endovascular grafting is a minimally invasive method to treat an aortic aneurysm. Instead of an open aneurysm repair in which your chest and abdomen are surgically opened, your surgeon may consider a procedure called an endovascular aneurysm repair (EVAR).
The Endurant II AAA stent graft (Medtronic) is a stent-graft composed with highly elastic nitinol stents with a high-density polyester fiber. Nitinol is an alloy of titanium and nickel and has been shown to have several advantages which include greater resistance to crushing forces as well as lower bending stress when placed within tortuous vessels (which is sometimes the case with aortic aneurysms).
Nitinol is also safe with use of magnetic resonance imaging (MRI). The Endurant stent graft system is often employed in challenging endovascular repairs (e.g. close proximity of the aneurysm to the renal arteries or tortuous aorta). Even while including results from difficult repairs, studies have shown that success and complication rates are comparable to other stent grafts.