Aorfix Stent Graft for Abdominal Aortic Aneurysms Reduces the Risk of Proximal Type 1 Endoleak in Angulated Necks: Bench-Test Study

Abstract

Neck angulation (NA) is an important risk factor for type 1 proximal endoleaks following stenting of abdominal aortic aneurysms. The Aorfix (Lombard Medical, Oxon, UK) is a new flexible stent graft designed to overcome this issue. The aim of this study was to compare the endoleak flow rate (EFR) in relation to NA between the Aorfix and other manufactured stent grafts. A flow model with silicone proximal and distal necks was used. EFRs corresponding to 10 neck angles between 0 and 70° were measured. Eight stent grafts were tested: Aorfix, Ancure (Guidant, Indianapolis, IN), Powerlink (Endologix, Irvine, CA), AneuRx (Medtronic, Sunnyvale, CA), Excluder (W.L. Gore & Associates, Flagstaff, AZ), Zenith and Zenith-Flex (Cook Inc., Bloomington, IN), and Lifepath (Edwards Lifesciences, Irvine, CA). For all stent grafts except the Aorfix, the EFR was greater than at baseline for NA ≥ 30° ( p < .01). The EFR at NA ≥ 30° was lower with the Aorfix compared with the other stent grafts ( p < .01). NA had no influence on the EFR with the Aorfix. The Aorfix may decrease the incidence of proximal type 1 endoleak in patients with a severely angulated aortic neck.