Two-Year Results of a Multicenter Prospective Observational Study of the Zenith Spiral-Z Limb Deployed in the External Iliac Artery During Endovascular Aneurysm Repair

Naoki Fujimura; Tomohiro Imazuru; Hitoshi Matsumura; Tsuyoshi Shibata; Tadashi Furuyama; Kenjiro Kaneko; Hidetoshi Uchiyama; Noriyasu Morikage; Takayuki Uchida; Eiichi Teshima; Terutoshi Yamaoka; Hiroshi Masuhara; Hideki Ueda; Mamoru Arakawa; Togo Norimatsu; Hideaki Obara; Seiji Onitsuka

doi:10.1253/circj.CJ-20-0195

Cardiovascular Surgery

Two-Year Results of a Multicenter Prospective Observational Study of the Zenith Spiral-Z Limb Deployed in the External Iliac Artery During Endovascular Aneurysm Repair

Naoki Fujimura, Tomohiro Imazuru, Hitoshi Matsumura, Tsuyoshi Shibata, Tadashi Furuyama, Kenjiro Kaneko, Hidetoshi Uchiyama, Noriyasu Morikage, Takayuki Uchida, Eiichi Teshima, Terutoshi Yamaoka, Hiroshi Masuhara, Hideki Ueda, Mamoru Arakawa, Togo Norimatsu, Hideaki Obara, Seiji Onitsuka

Author information

Naoki Fujimura
Division of Vascular Surgery, Saiseikai Central Hospital [Japan]
Tomohiro Imazuru
Department of Cardiovascular Surgery, Teikyo University Hospital [Japan]
Hitoshi Matsumura
Department of Cardiovascular Surgery, Fukuoka University School of Medicine [Japan]
Tsuyoshi Shibata
Department of Cardiovascular Surgery, Hakodate Municipal Hospital [Japan]
Tadashi Furuyama
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University [Japan]
Kenjiro Kaneko
Department of Vascular Surgery, Shin-yurigaoka General Hospital [Japan]
Hidetoshi Uchiyama
Department of Vascular Surgery, Tsuchiura Kyodo General Hospital [Japan]
Noriyasu Morikage
Department of Vascular Surgery, Yamaguchi University [Japan]
Takayuki Uchida
Department of Cardiovascular Surgery, Iiduka Hospital [Japan]
Eiichi Teshima
Department of Cardiovascular Surgery, Fukuoka Wajiro Hospital [Japan]
Terutoshi Yamaoka
Department of Vascular Surgery, Matsuyama Red Cross Hospital [Japan]
Hiroshi Masuhara
Department of Cardiovascular Surgery, Toho University Omori Medical Center [Japan]
Hideki Ueda
Department of Cardiovascular Surgery, Chiba University [Japan]
Mamoru Arakawa
Department of Cardiovascular Surgery, Nerima Mitsugaoka Hospital [Japan]
Togo Norimatsu
Department of Vascular Surgery, Sakakibara Memorial Hospital [Japan]
Hideaki Obara
Department of Surgery, Keio University School of Medicine [Japan]
Seiji Onitsuka
Department of Surgery, Kurume University School of Medicine [Japan]

Keywords: Endovascular aneurysm repair, External iliac artery, Hypogastric artery embolization, Polyester fabric, Zenith Spiral-Z limb

JOURNAL OPEN ACCESS FULL-TEXT HTML

2020 Volume 84 Issue 10 Pages 1764-1770

DOI https://doi.org/10.1253/circj.CJ-20-0195

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Abstract

Background:Limited data is available on the use of a polyester graft limb with a helical stent configuration deployed in the external iliac artery (EIA) during endovascular aneurysm repair (EVAR), so we prospectively analyzed the efficacy of the Zenith Spiral-Z limb deployed in the EIA.

Methods and Results:Patients undergoing EVAR using a Zenith stent-graft and Spiral-Z limb deployed in the EIA were prospectively registered in 24 Japanese institutions from June 2017 to November 2017. In total, 65 patients (74 limbs) (mean age: 77.1±8.0 years, 87.7% men, mean abdominal aortic aneurysm (AAA) diameter: 51.9±7.2 mm, mean iliac artery aneurysm (IAA) diameter: 38.3±10.0 mm) were registered and followed up. The most common reason for deployment in the EIA was a common IAA (43 limbs, 58.1%), and 8 limbs (10.8%) had a bare nitinol stent placed at the Spiral-Z limb. A total of 61 patients (70 limbs) completed a 24-month follow-up. There were 2 Spiral-Z limb stenoses and 1 occlusion, leading to a primary patency of 95.5% and a secondary patency of 100%, at 24 months. Buttock claudication occurred in 24.3% of the limbs treated at 1 month but decreased to 4.3% at 24 months.

Conclusions:Our multicenter prospective study showed that Spiral-Z limb deployed in the EIA was associated with satisfactory results and seems to be a durable option, even in the era of iliac branch devices.

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