Correlation of hostile neck with infrarenal EVAR type 1a, by Emily Kirkham.

EMILY KIRKHAM

vascular reg presently at Gloucester.

Wilson Kulkarni and Cooper listed.

looked through their database since 2009

relationship between AAA anatomy, neck ultilisation and 1a endoleak

10 year patient recruited from DB

a=neck length

b=neck diameter

neck alpha angle

length of neck coverage

1a in 5%: 15 patients

Every pt who had a 1a had at least one non-desirable characteristic (NDC)

1 NDC : 5% risk

More than 1 NDC: 25% risk

NDC defined as anatomical features that rendered the specific graft being off IFU.

% endoleak increases with increase in % NDC factors

- paper supports mantra of strict adherence to IFU.

Qn: type of stent

Majority used were Gore and Medtronic.

Qn: Has practice in the unit changed over time?

Earlier used to push the limits of EVAR

Now doing more of non op care rather than pushing the limtis of IFU in light of these findings and of NICE guidance.

I had a nice d/w Gabriel Sayer from Romford at the back of the room as the session ended with this talk. What would be good to explore would also be: What were the actual consequences of these 1a ELs? And also, another way to look at the data would be to say that 95% cases with 1 NDC did NOT have an EL.