Sizes of endografts for endovascular aortic repair : do few fit most?

AIM: The endoprostheses for the endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA), are currently available in many sizes in reference to the aortic diameters of the proximal neck, but often not all of them are really used. Aim of our work was to review in our experience the most frequent proximal aortic diameters of main bodies that were used, among all those available for EVAR, with respect to the native proximal aortic neck. METHODS: All the sizes of main bodies of the different endografts used for EVAR from 2000 to 2016 were retrospectively counted. For each endograft, we calculated the number of times each size of main bodies’ proximal diameter was used. The mean diameter of the proximal aortic neck was also calculated for each group of main bodies. RESULTS: From 2000 to 2016, 607 patients underwent EVAR for infrarenal AAA. Overall, mean diameter of the proximal aortic neck was 23.4 ± 0.5 mm (median 23.1 mm, IQR 22.2–23.7 mm). The most frequently used main bodies had a 28 mm, 26 mm and 25 mm proximal diameter (161/607, 26.5%; 147/607, 24.2%; 122/607, 20.1% respectively), for a mean proximal neck diameter of 23.2 ± 0.5 mm, 22.2 ± 0.4 mm and 22.1 ± 0.2 respectively. The least frequently used main bodies had a 21 mm and a 36 mm proximal diameter (3/607 times each, 0.5%), for a mean proximal neck diameter of 18.1 ± 0.2 mm and 32.4 ± 0.8 mm respectively. CONCLUSIONS: In our experience, the most frequently used main bodies had a 25, 26 and 28 mm proximal diameters.