Mid- to Long-Term Outcome Results of the Ovation Stent Graft

Background: To report mid-term to long-term outcome data for endovascular aortic repair using the Ovation stent-graft system (Endologix, Santa Rosa, CA) in a single university center. Methods: All patients treated with the Ovation stent graft between February 2012 and January 2019 were included. Patient demographics, anatomical and operative details, as well as follow-up data including complications, need for further interventions, and mortality were analyzed. Results: A total of 74 patients (93% males; mean age, 74.5 years) were treated with the Ovation stent graft. The median maximal aortic diameter was 60 mm (range, 36-100). Sixty-two of 74 patients (83.8%) were considered to have a hostile neck. About 33% had a (reversed) conical neck, 59% had circumferential neck calcification (>50%), and 39% had significant neck thrombus (>50%). Technical success rate was 91.89%. Despite additional measures, 4 patients had a persistent type Ia endoleak on completion angiography, of which 3 disappeared on the first postoperative computed tomography angiography. Mean follow-up duration was 31.62 months +/- 21.3 (range, 0-72.74 months). Twenty-four patients had a follow-up time of at least 36 months. Freedom from reintervention at 1, 2, 3, and 5 years was 92.7%, 90.8%, 80.1%, and 80.1%, respectively. Estimated freedom from mortality at 1, 2, 3, and 5 years was 96.8%, 95.0%, 87.3%, and 68.5%, respectively. No late type Ia or type III endoleak was detected during follow-up. No aneurysm-related mortality was seen. Conclusions: Our mid- to long-term experience with the Ovation stent-graft system demonstrates safe and durable results without late type Ia or type III endoleak.