358 Driving Endovascular Solutions for Abdominal Aortic Aneurysms: A 9-Year International Experience with the Fenestrated Anaconda Endograft

Endovascular aortic repair (EVAR) has become the mainstay treatment for abdominal aortic aneurysms and is associated with optimal outcomes. However, there remains a risk of complications requiring reintervention. Several EVAR devices exist commercially, yet, the Fenestrated Anaconda™ (FA) has demonstrated outstanding results. This study aims to presents a 9-year cross-sectional international analysis of custom-made FA outcomes. Patient data was collected prospectively in 27 countries over 9 years and stored in an international registry. This was later retrieved and analysed retrospectively. A total of 5058 patients received the FA endograft. This was indicated either due to complex anatomy for competitor devices (n = 3891, 76.9%) or based on surgeon preference (n = 1167, 23.1%). Overall, the FA was utilised to rescue 2987 (59%) failed previous EVARs. The predominant device category and proximal ring stent configuration were bifurcate (83.6%) and standard (64.5%). Most devices were delivered within 6-8 weeks (55.4%) of diagnosis and 95% came with a prototype. As for clinical outcomes, both survival and TVP were 100% during the first 6 postoperative years but dropped to 77.1% and 81% thereafter. A sac regression of 0-30% was observed in 4772 (94.3%) patients over the first 4 years, whilst all patients had 20-45% sac regression in years 5-9 of follow-up. No cases of endograft migration or reintervention were recorded. All clinical outcomes were further stratified by indication group. The custom-made FA endograft features a highly unique and innovative design which enables it to treat highly complex aortic anatomy while achieving favourable results.