Technical Characteristics of the Ovation Alto for the Treatment of Abdominal Aortic Aneurysms: Application to Challenging Anatomies

Abstract

The Ovation Alto design repositions the maximum diameter of the proximal sealing ring at 7 mm below the lowermost renal artery. Although it has been introduced to address abdominal aortic aneurysms with short necks ≥7 mm, we present further applications of Alto in other neck irregularities, presenting four representative challenging cases with a short, wide, and conical neck, as well a juxtarenal aneurysm. At 1-month follow-up, there was 100% technical and clinical success.

Keywords

Ovation Alto - abdominal aortic aneurysm - endovascular aneurysm repair - wide neck - juxtarenal aneurysm

Publikationsverlauf

Eingereicht: 11. Juli 2022

Angenommen: 07. März 2023

Accepted Manuscript online:
09. März 2023

Artikel online veröffentlicht:
31. Mai 2023

• References

• 1 Powell JT, Sweeting MJ, Ulug P. et al; EVAR-1, DREAM, OVER and ACE Trialists. Meta-analysis of individual-patient data from EVAR-1, DREAM, OVER and ACE trials comparing outcomes of endovascular or open repair for abdominal aortic aneurysm over 5 years. Br J Surg 2017; 104 (03) 166-178
• 2 Marone EM, Freyrie A, Ruotolo C. et al. Expert opinion on hostile neck definition in endovascular treatment of abdominal aortic aneurysms (a Delphi Consensus). Ann Vasc Surg 2020; 62: 173-182
• 3 Antoniou GA, Georgiadis GS, Antoniou SA, Kuhan G, Murray D. A meta-analysis of outcomes of endovascular abdominal aortic aneurysm repair in patients with hostile and friendly neck anatomy. J Vasc Surg 2013; 57 (02) 527-538
• 4 Schanzer A, Greenberg RK, Hevelone N. et al. Predictors of abdominal aortic aneurysm sac enlargement after endovascular repair. Circulation 2011; 123 (24) 2848-2855
• 5 Oliveira-Pinto J, Oliveira N, Bastos-Gonçalves F. et al. Long-term results of outside “instructions for use” EVAR. J Cardiovasc Surg (Torino) 2017; 58 (02) 252-260
• 6 Holden A, Lyden S. Initial experience with polymer endovascular aneurysm repair using the Alto stent graft. J Vasc Surg Cases Innov Tech 2020; 6 (01) 6-11
• 7 de Donato G, Pasqui E, Panzano C, Galzerano G, Cappelli A, Palasciano G. Early experience with the new ovation alto stent graft in endovascular abdominal aortic aneurysm repair. EJVES Vasc Forum 2021; 54: 7-12
• 8 Jordan Jr. WD, Ouriel K, Mehta M. et al; Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry ANCHOR, Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry ANCHOR. Outcome-based anatomic criteria for defining the hostile aortic neck. J Vasc Surg 2015; 61 (06) 1383-90.e1