Nowadays, Endovascular Aneurysm (EVAR) constitutes the method of choice for the treatment of Abdominal Aortic Aneurysm repair, since it is associated with lesser perioperative and early postoperative morbidity and mortality when compared with open repair. However, this advantage is lost after 3 years, mainly due to higher rates of comlications and greater need of secondary reinterventions. The commonest reasons of concern are a) endograft's mogration due to loss of central sealing, b) peripheral leak at the iliacs, c) early and late iliac limb thrombosis attributed to local geometrical factors (kinking, tortuosity, angulations and stenosis).
Endograft manufacturing is focused on the aforementioned factors in order to counteract for the potential complications. The majority of clinical studies are limited in reporting on clinical performance with respect to adverse effects free survival rate and rate of reinterventions. However, this philosophy leads to copy-editing of endografts' features, while direct comparison between the endografts is avoided.
On the other side of the field, the bioengineering studies assess the mechanical properties of the grafts either in vitro or via computational simulations; however, the clinical input is often missing leading to misconceptions or limitation of the clinical utility of the the results of these studies.
The aim of this topic is to present 1) clinical studies (even small case series, initially) reporting on the early-, mid- and long term performance of currently used or recently introduced endografts, 2) Focusing on the unique mechanical properties that render each endograft unique 3) Present tutorials that guide clinicians to identify the unique mechanical / hemodynamic needs of AAAs that render certain endografts eligible for those AAA while other endografts less preferable for the specific geometry, 4) Provide better communication between clinicians and bioengineers.
Nowadays, Endovascular Aneurysm (EVAR) constitutes the method of choice for the treatment of Abdominal Aortic Aneurysm repair, since it is associated with lesser perioperative and early postoperative morbidity and mortality when compared with open repair. However, this advantage is lost after 3 years, mainly due to higher rates of comlications and greater need of secondary reinterventions. The commonest reasons of concern are a) endograft's mogration due to loss of central sealing, b) peripheral leak at the iliacs, c) early and late iliac limb thrombosis attributed to local geometrical factors (kinking, tortuosity, angulations and stenosis).
Endograft manufacturing is focused on the aforementioned factors in order to counteract for the potential complications. The majority of clinical studies are limited in reporting on clinical performance with respect to adverse effects free survival rate and rate of reinterventions. However, this philosophy leads to copy-editing of endografts' features, while direct comparison between the endografts is avoided.
On the other side of the field, the bioengineering studies assess the mechanical properties of the grafts either in vitro or via computational simulations; however, the clinical input is often missing leading to misconceptions or limitation of the clinical utility of the the results of these studies.
The aim of this topic is to present 1) clinical studies (even small case series, initially) reporting on the early-, mid- and long term performance of currently used or recently introduced endografts, 2) Focusing on the unique mechanical properties that render each endograft unique 3) Present tutorials that guide clinicians to identify the unique mechanical / hemodynamic needs of AAAs that render certain endografts eligible for those AAA while other endografts less preferable for the specific geometry, 4) Provide better communication between clinicians and bioengineers.
