The PROTAGORAS 2.0 Study to Identify Sizing and Planning Predictors for Optimal Outcomes in Abdominal Chimney Endovascular Procedures

ObjectiveThe aim was to identify predictors of adequate pre-operative sizing and planning for chimney endovascular aortic repair (ChEVAR) in order reduce the incidence persistent type Ia endoleaks (IaELs) without influencing graft (CG) patency.MethodsConsecutive patients who underwent ChEVAR between January 2009 December 2017 at a single centre were evaluated retrospectively. Included treated with one device combination (Medtronic Endurant mated Getinge Advanta V12/iCast) placement or double CG. The freedom from IaEL related re-interventions primary CG patency estimated by measuring stent oversizing (OS), total neck length (TNL), composite parameter (L-OS: TNL [mm] + OS [%]).ResultsSeventy-three 101 CGs (45 single, 28 double) met inclusion criteria. median radiological follow up 25.5 (interquartile range [IQR] 12–48) months. Freedom re-intervention achieved 94.6% 38.5% (IQR 30%–44%, p = .004), 19 mm (16–25 mm, .62), L-OS 59 (51–65, .018). Primary 95% cases 36% (29%–42%, .008), (15.5–26 .91), 57 (50–64, .005). By using receiver operating characteristic curve, an optimal cut off prevent identified 30% (p < .001; 55, .006) avoid stenosis/occlusions 42% 65, .001). In multivariable analysis, endograft only independent preventive (odds ratio, 0.78; confidence interval, 0.61–0.99).ConclusionWith Endurant-Advanta V12/iCast combination, least (range 30%–42%) should be used likewise ensure patency. Consecutive [%]). Seventy-three 0.61–0.99). With