PALMAZ® XL stent for treatment of proximal endoleaks after endovascular repair of infrarenal aortic aneurysms. EVAR in AAA with hostile neck - Possibilities and limits [Der PALMAZ®-XL-Stent zur Behandlung von proximalen Endoleaks nach endovaskulärem Repair infrarenaler Aortenaneurysmen. EVAR beim AAA mit "hostile neck" - M̈oglichkeiten und Grenzen]

Background. Successful treatment of infrarenal abdominal aortic aneurysms (AAA) with endovascular aneurysm repair (EVAR) stent prostheses is particularly dependent on a good apposition of the prosthesis to the aortic wall. Proximal endoleaks (EL) can be resolved by dilatation of the EVAR at the proximal attachment zone with a PALMAZ® XL (Cordis, Diegem, Belgium) stent. Objectives. This article presents own results and an overview of the literature about this method. Methods. A total of nine consecutive patients (median age 78 years) who were treated with a PALMAZ® XL stent due to a primary type Ia EL after EVAR implantation (from February 2008 to March 2013) were included in this retrospective analysis. In addition a PubMed search with the keywords "aortic aneurysm", "endoleak", "endovascular" and "palmaz stent" was carried out. Results. The PALMAZ® XL stent implantation showed a technical success rate of 90% (one dislocation of stent) with a sufficient elimination of all type Ia ELs (100%). The median follow-up time was 23 months (range 2-36 months). Within the follow up interval no recurrent type Ia EL was found in the control computed tomography (CT) angiographies and therefore no reinterventions were needed. The PubMed search revealed 3 relevant articles reporting on 77 patients. The technical success rate was 99% (77 out of 78) and the treatment success rate was also 99% (76 out of 77). Discussion. In conclusion, implantation of a PALMAZ® XL stent is a cost-efficient and durable method to treat type Ia ELs after EVAR implantation.