Infrarenal Aortic Treatment With AFX2 Endograft: Results From a Multicentric, International, Non-Randomized, Prospective Registry-the AFX2-LIVE Study.

IF 1.7 2区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Pasqualino Sirignano, Francesco Andreoli, Andrea Gaggiano, Giancarlo Accarino, Nicola Tusini, Filippo Benedetto, Pierfrancesco Veroux, Roberto Silingardi, Maurizio Taurino, Francesco Speziale
{"title":"Infrarenal Aortic Treatment With AFX2 Endograft: Results From a Multicentric, International, Non-Randomized, Prospective Registry-the AFX2-LIVE Study.","authors":"Pasqualino Sirignano, Francesco Andreoli, Andrea Gaggiano, Giancarlo Accarino, Nicola Tusini, Filippo Benedetto, Pierfrancesco Veroux, Roberto Silingardi, Maurizio Taurino, Francesco Speziale","doi":"10.1177/15266028241284364","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>To confirm real-world clinical practice results reported with anatomically fixed bifurcated endograft, a physician-initiated study was designed-AFX2-LIVE registry.</p><p><strong>Materials and methods: </strong>From November 2019 to August 2021, investigators enrolled all consecutive patients treated with AFX2 (Endologix Inc., Irvine, CA, USA) endograft. Patients with abdominal aortic aneurysms (AAAs), penetrating aortic ulcers (PAU), and isolated infrarenal aortic dissections were included. Clinical and anatomical data, including baseline, intraoperative, and in-hospital details, as well as follow-up data, were collected in an anonymized prospectively compiled database. The primary endpoint of this study was to evaluate the technical and clinical success of endovascular aortic repair (EVAR) using AFX2 endograft.</p><p><strong>Results: </strong>A total of 535 patients were enrolled from 43 Italian and Spanish centers and analyzed according to the protocol. Four hundred eighty-nine patients were male (91.4%), with a mean age of 75±8.92 years (range 52-94). Four hundred sixty-six patients (87.1%) were treated for AAA, 49 (9.3%) for PAU, and 20 (3.6%) for isolated abdominal aortic dissection. A proximal extension was needed in 48% of the cases. Assisted technical success was achieved in all but one patient (99.8%). At 30 days follow-up, no AAA-related deaths were recorded, and nine patients (1.6%) required reintervention. At a mean follow-up period of 15.22±13.65 (range 1-53) months, data were available for 479 patients (89.5%). Clinical success was achieved in 98.2% (95% confidence interval [CI]: 96.4-99.1) at 3 months, 93.9% (95% CI: 90.1-96.1) at 1 year, and 74.1% (95% CI: 62.8-82.4) at 4 years follow-up. The estimated freedom from all-cause mortality was 97.7%, 93.4%, 81.6%, 77.5%, and 70.9%, and freedom from AAA-related mortality was 100%, 99.6%, 99.6%, 99.6%, and 97.3% at 3, 12, 24, 36, and 48 months, respectively. Twenty reinterventions (3.7%) were required in 19 patients, of which 3 late open conversions (0.6%) were performed, and 2 AAA-related deaths were observed.</p><p><strong>Conclusion: </strong>This study demonstrated excellent clinical and technical success rates of EVAR with anatomically fixed endografts, providing valuable insights into real-world clinical outcomes.</p><p><strong>Clinical impact: </strong>The AFX2-LIVE study could have a significant impact by providing robust evidence supporting the effectiveness and safety of EVAR using bifurcated endografts with anatomical fixation in real-world clinical practice, ultimately leading to improved outcomes and enhanced patient care in the management of abdominal aortic pathologies.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028241284364"},"PeriodicalIF":1.7000,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Endovascular Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15266028241284364","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: To confirm real-world clinical practice results reported with anatomically fixed bifurcated endograft, a physician-initiated study was designed-AFX2-LIVE registry.

Materials and methods: From November 2019 to August 2021, investigators enrolled all consecutive patients treated with AFX2 (Endologix Inc., Irvine, CA, USA) endograft. Patients with abdominal aortic aneurysms (AAAs), penetrating aortic ulcers (PAU), and isolated infrarenal aortic dissections were included. Clinical and anatomical data, including baseline, intraoperative, and in-hospital details, as well as follow-up data, were collected in an anonymized prospectively compiled database. The primary endpoint of this study was to evaluate the technical and clinical success of endovascular aortic repair (EVAR) using AFX2 endograft.

Results: A total of 535 patients were enrolled from 43 Italian and Spanish centers and analyzed according to the protocol. Four hundred eighty-nine patients were male (91.4%), with a mean age of 75±8.92 years (range 52-94). Four hundred sixty-six patients (87.1%) were treated for AAA, 49 (9.3%) for PAU, and 20 (3.6%) for isolated abdominal aortic dissection. A proximal extension was needed in 48% of the cases. Assisted technical success was achieved in all but one patient (99.8%). At 30 days follow-up, no AAA-related deaths were recorded, and nine patients (1.6%) required reintervention. At a mean follow-up period of 15.22±13.65 (range 1-53) months, data were available for 479 patients (89.5%). Clinical success was achieved in 98.2% (95% confidence interval [CI]: 96.4-99.1) at 3 months, 93.9% (95% CI: 90.1-96.1) at 1 year, and 74.1% (95% CI: 62.8-82.4) at 4 years follow-up. The estimated freedom from all-cause mortality was 97.7%, 93.4%, 81.6%, 77.5%, and 70.9%, and freedom from AAA-related mortality was 100%, 99.6%, 99.6%, 99.6%, and 97.3% at 3, 12, 24, 36, and 48 months, respectively. Twenty reinterventions (3.7%) were required in 19 patients, of which 3 late open conversions (0.6%) were performed, and 2 AAA-related deaths were observed.

Conclusion: This study demonstrated excellent clinical and technical success rates of EVAR with anatomically fixed endografts, providing valuable insights into real-world clinical outcomes.

Clinical impact: The AFX2-LIVE study could have a significant impact by providing robust evidence supporting the effectiveness and safety of EVAR using bifurcated endografts with anatomical fixation in real-world clinical practice, ultimately leading to improved outcomes and enhanced patient care in the management of abdominal aortic pathologies.

使用 AFX2 内植物治疗肾下主动脉:一项多中心、国际性、非随机、前瞻性登记--AFX2-LIVE 研究的结果。
简介:为证实解剖固定分叉内植物的真实临床实践结果,设计了一项由医生发起的研究--AFX2-LIVE 注册:为了证实解剖固定分叉内植物的实际临床实践结果,我们设计了一项由医生发起的研究--AFX2-LIVE 登记:从 2019 年 11 月到 2021 年 8 月,研究人员登记了所有接受 AFX2(Endologix Inc.纳入的患者包括腹主动脉瘤(AAA)、穿透性主动脉溃疡(PAU)和孤立的肾下主动脉夹层。临床和解剖学数据,包括基线、术中和院内细节以及随访数据,都收集在一个匿名的前瞻性数据库中。这项研究的主要终点是评估使用AFX2内植物进行血管内主动脉修复(EVAR)的技术和临床成功率:共有来自 43 个意大利和西班牙中心的 535 名患者入选,并按照方案进行了分析。489名患者为男性(91.4%),平均年龄为75±8.92岁(52-94岁不等)。466 名患者(87.1%)因 AAA 接受治疗,49 名(9.3%)因 PAU 接受治疗,20 名(3.6%)因孤立性腹主动脉夹层接受治疗。48%的病例需要进行近端延伸。除一名患者(99.8%)外,其他患者均取得了辅助技术成功。在 30 天的随访中,没有记录到与 AAA 相关的死亡病例,有 9 名患者(1.6%)需要再次介入治疗。平均随访时间为 15.22±13.65(范围 1-53)个月,有 479 名患者(89.5%)的数据可用。随访 3 个月、1 年和 4 年的临床成功率分别为 98.2%(95% 置信区间 [CI]:96.4-99.1)、93.9%(95% 置信区间 [CI]:90.1-96.1)和 74.1%(95% 置信区间 [CI]:62.8-82.4)。在3、12、24、36和48个月时,估计免于全因死亡率的比例分别为97.7%、93.4%、81.6%、77.5%和70.9%,免于AAA相关死亡率的比例分别为100%、99.6%、99.6%、99.6%和97.3%。19例患者中需要进行20次再干预(3.7%),其中进行了3次晚期开放转流(0.6%),观察到2例AAA相关死亡:这项研究表明,使用解剖固定的内植物进行EVAR的临床和技术成功率极高,为真实世界的临床结果提供了有价值的见解:临床影响:AFX2-LIVE 研究将产生重大影响,它将提供有力的证据支持在实际临床实践中使用解剖固定的分叉内植物进行 EVAR 的有效性和安全性,最终改善腹主动脉病变治疗的结果并加强对患者的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
5.30
自引率
15.40%
发文量
203
审稿时长
6-12 weeks
期刊介绍: The Journal of Endovascular Therapy (formerly the Journal of Endovascular Surgery) was established in 1994 as a forum for all physicians, scientists, and allied healthcare professionals who are engaged or interested in peripheral endovascular techniques and technology. An official publication of the International Society of Endovascular Specialists (ISEVS), the Journal of Endovascular Therapy publishes peer-reviewed articles of interest to clinicians and researchers in the field of peripheral endovascular interventions.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信