TY - JOUR
T1 - Identifying and addressing the limitations of EVAR technology
AU - Belvroy, Viony M.
AU - Houben, Ignas B.
AU - Trimarchi, Santi
AU - Patel, Himanshu J.
AU - Moll, Frans L.
AU - Van Herwaarden, Joost A.
PY - 2018/8/3
Y1 - 2018/8/3
N2 - Introduction: Endovascular aortic repair (EVAR) has improved over the last two decades. Approximately 80% of the patients presenting with an abdominal aortic aneurysm (AAA) is nowadays primarily treated with EVAR. Areas covered: In this review, the differences between endovascular and open repair, the clinical characteristics needed for EVAR, the role of clinical imaging and the developments in EVAR technology will be discussed. Early mortality is lower in EVAR as compared to open repair, whereas this benefit is lost after 3 years postoperatively. EVAR comes with a high reintervention rate, with endoleak being the most important predictive factor for reintervention. Expanding technical possibilities have allowed surgeons to choose from a palate of endovascular approaches in aneurysm patients with challenging anatomies. Expert commentary: Although EVAR has taken a giant leap forward in development, the new developments have seemed to surpass the long-term limitations with older devices. It is important to start focusing on the current limitations of EVAR, in particular the durability of devices in the human variable anatomic and dynamic environment.
AB - Introduction: Endovascular aortic repair (EVAR) has improved over the last two decades. Approximately 80% of the patients presenting with an abdominal aortic aneurysm (AAA) is nowadays primarily treated with EVAR. Areas covered: In this review, the differences between endovascular and open repair, the clinical characteristics needed for EVAR, the role of clinical imaging and the developments in EVAR technology will be discussed. Early mortality is lower in EVAR as compared to open repair, whereas this benefit is lost after 3 years postoperatively. EVAR comes with a high reintervention rate, with endoleak being the most important predictive factor for reintervention. Expanding technical possibilities have allowed surgeons to choose from a palate of endovascular approaches in aneurysm patients with challenging anatomies. Expert commentary: Although EVAR has taken a giant leap forward in development, the new developments have seemed to surpass the long-term limitations with older devices. It is important to start focusing on the current limitations of EVAR, in particular the durability of devices in the human variable anatomic and dynamic environment.
KW - Abdominal aortic aneurysm
KW - endoprosthesis
KW - endovascular aortic therapy
KW - stent graft
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U2 - 10.1080/17434440.2018.1505496
DO - 10.1080/17434440.2018.1505496
M3 - Review article
AN - SCOPUS:85052139357
SN - 1743-4440
VL - 15
SP - 541
EP - 554
JO - Expert Review of Medical Devices
JF - Expert Review of Medical Devices
IS - 8
ER -