A Retrospective Review of Palmaz Stenting of the Aortic Neck for Endovascular Aneurysm Repair

BackgroundTo review the aortic neck characteristics, graft types, and technical results of Palmaz stent placement as an adjunct to endovascular aneurysm repair (EVAR).MethodsA retrospective review of 110 consecutive EVAR cases identified 18 cases in which Palmaz stents were placed as an adjunct to EVAR. Graft types, hostile aortic neck features (neck diameter: >26 mm, length: <15 mm, angulation: >60°, reverse taper necks), and treatment success were identified.ResultsTechnical success in the placement of a proximal Palmaz stent was achieved in 17 of 18 cases. Palmaz stenting was attempted for the treatment of type I endoleak in 17 of 18 patients. One prophylactic stent was deployed in the setting of hostile neck anatomy. Proximal stent deployment resulted in immediate treatment success of type I endoleaks in 16 of 17 patients—one failure occurred in a patient who presented with a delayed type I endoleak. Analysis of aortic neck anatomy revealed that two of 18 patients had no criteria for a hostile neck, seven had one criterion, and nine met at least two criteria. With respect to stent–graft types, nine of 18 (50%) cases used the Endologix Powerlink, six used Gore Excluder, two used Cook Zenith, and one used Medtronic Talent. With a mean follow-up of 254 days, 16 of 17 type I endoleaks remain resolved.ConclusionsWith proper patient selection and additional adjunctive treatments, Palmaz stenting can effectively treat proximal type I endoleaks.