Conformability and Efficacy of the Zenith Spiral Z Leg Compared with the Zenith Flex Leg in Endovascular Aortic Aneurysm Repair. Annals of vascular surgery Iwakoshi, S. n., Nakai, T. n., Ichihashi, S. n., Inoue, T. n., Sakaguchi, S. n., Hirose, T. n., Tabayashi, N. n., Watkins, A. C., Kichikawa, K. n. 2019


To compare the outcome of endovascular aortic aneurysm repair (EVAR) using the Zenith Spiral Z leg (ZSLE) versus the Zenith Flex leg (TFLE).Patients undergoing EVAR using TFLE or ZSLE between October 2009 and December 2017 were retrospectively reviewed. Clinical endpoints were freedom from limb related complications and change of arterial tortuosity indexes. Limb related complication was defined as limb stenosis or occlusion, stent kink, stent disconnection and type1b endoleak. Tortuosity indexes were measured on the preoperative and postoperative CT and compared.A total of 56 patients (11 female, average age was 78.5 ± 5.5 years), 111 limbs were enrolled. One patient was treated using Aorto-uni iliac device. TFLE was deployed in 43 limbs (22 patients), ZSLE in 68 limbs (34 patients). Average follow up was 43.6±27.6 months. In follow-up, eight limb related complications occurred in TFLE group and two in ZSLE group. Freedom from limb related complications at three years was 84.4% in TFLE group and 96.1% in ZSLE group (p=0.039). There was no statistically significant difference between TFLE and ZSLE group in the Aorto-iliac tortuosity change (TFLE vs ZSLE; -6.1 ± 5.8 vs -4.9 ± 6.4, p=0.324). However, there was significant in the Iliac tortuosity change (-7.4 ± 11.7 vs -3.0 ± 7.9, p=0.022).Spiral Z leg showed less occurrence of limb related complications and less iliac artery tortuosity index change compared to Zenith Flex leg. The spiral Z provided better conformability as a stentgraft limb.

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