Endoanchoring systems in endovascular aortic aneurysm repair
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 7 sources, which was discussed by the committee. The evidence included 2 systematic reviews, 1 non-randomised comparative study, 2 cohort studies, 1 single-arm study, which was also included in the systematic reviews, and a case series of reports on the US Food and Drug Administration Manufacturer and User Facility Device Experience Database. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: prevention of aneurysm rupture and prevention of endovascular aortic aneurysm repair graft migration.
3.3 The professional experts and the committee considered the key safety outcomes to be: bleeding, infection and device migration.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 The committee was informed that the risk of migration with EVAR is related to the anatomy of the aorta and the choice of endograft.
3.6 The committee was informed that the use of endoanchors in a primary EVAR procedure increases the exposure to X-rays during the procedure.
3.7 The committee was informed that endoanchors are difficult to remove.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
December 2021
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