Unibody bifurcated endografts have the advantage of reducing the operative time,
avoiding migration and iliac limb dislocation in patient with abdominal aortic
aneurysm (AAA). We report our long-term experience in patients who underwent
endovascular aortic repair (EVAR) due to infrarenal AAA with Endologix
AFX endograft system. Between January 2013–December 2018, 68
patients with infrarenal AAA had EVAR procedure with Endologix
AFX endograft system. Mean follow-up was 40.4 19.5
months, and all patients had computed tomography periodically, with colored
Doppler ultrasonography (CDUS) every six months. Mean age was 68.5 7.1
years and, 63 (92.6%) patients were male. Early mortality, renal complications,
stent-graft migration and cardiac complications were not seen in early
post-operative period. There was no early mortality in the group and no
conversion to open repair. In long-term follow-up 12 patients (17.6%) had
endoleak (5 with type II, 7 with type III). Overall survival estimated by
Kaplan-Meier analysis was 94.1% at 1 year, 85.2% at 2 years, 74.1% at 3 years
and 54.0% at 5 years. Freedom from second intervention and conversion was 98.4%
at 1 year, 95.3% at 2 years, 93.3% at 3 years and 87.4% at 5 years. Endologix
AFX endograft provides a fast, safe and effective endograft for
the early period, therefore it seems more suitable for elderly and comorbid
patients. This endograft has low reintervention rates however according to our
results, aneurysms larger than 6 cm may have more sideway displacement
possibility and by this way type III endoleak. Proper patient selection and
sufficient overlap are the key issues. Close monitoring is mandatory at the
follow-up period.