Mid-term Results of the Anaconda Fenestrated Stent-Graft Proximal Sealing System in the Exclusion of Complex Abdominal Aortic Aneurysms

CONTEXT: Mid-term data on the Anaconda fenestrated stent-graft remain scarce in the literature. OBJECTIVE: The aim of this study was to evaluate the efficacy and durability of its Z-stent-free proximal sealing system. METHODS: All consecutive patients treated between January 2018 and May 2023 with the Anaconda Fenestrated stent-graft (Vascutek/Terumo, Scotland, UK) for complex abdominal aortic aneurysm (AAA) were retrospectively included in this monocentric study. The primary outcome was the occurrence of type Ia endoleak (EL). The secondary outcome was the evolution of the proximal sealing zone (PSZ), defined as proximal neck dilatation (PND) ≥3 mm, stent-graft migration (>10 mm), or the need for PSZ-related reintervention. Effective oversizing (OS) was calculated from the nominal stent-graft diameter and the mean aortic diameter at the PNR level on postoperative computed angiography (CT) angiography. RESULTS: A total of 111 patients were included (mean age 72±7.6 years, 86% male) with 69 juxta renal aneurysms (62.2%), 23 para-renal aneurysms (20.7%), and 19 proximal EL after EVAR (17.1%). The mean follow-up was 28.1±16.2 months. No primary type Ia EL was observed at discharge. During follow-up, 1 patient (