Vasc Spec Int.  2023 Dec;39(4):39. 10.5758/vsi.230076.

Endovascular Repair of a Failed Nellix Endograft Proximal Sealing Zone Using the Altura Stent-Graft: A Case Report and Literature Review

• Chatzelas DA
• Pitoulias AG
• Tsamourlidis GV
• Zampaka TN
• Potouridis AG
• Tachtsi MD
• Pitoulias GA

• KMID: 2550387
• DOI: http://doi.org/10.5758/vsi.230076

Abstract

Endovascular aortic aneurysm sealing (EVAS) with the Nellix endograft was initially considered a groundbreaking and acceptable alternative to conventional endovascular aortic aneurysm repair, with encouraging initial results. However, long-term follow-up has revealed a high incidence of endograft-related complications, such as caudal migration and type Ia endoleaks, indicating the need for reintervention. Managing failed EVAS remains challenging and is an ongoing topic of discussion, especially for high-risk patients. We describe a 70-year-old female who initially underwent EVAS with a Nellix endograft and presented after 5 years of follow-up with caudal endograft migration and a type Ia endoleak. The patient was treated with endovascular implantation of an Altura stent-graft, a relatively new low-profile device with a similar double stent configuration. Device migration and endoleaks were undetectable at 12 months of follow-up, suggesting that the Altura might offer a safe and efficient approach in cases of Nellix proximal failure.

Keyword

Abdominal aortic aneurysm; Endovascular aneurysm repair; Complications; Follow up study; Case reports