Low-Profile Altura® Endograft System Versus Standard-Profile Stent Grafts for Endovascular Aneurysm Repair - A Case-Matched Study

Q: Why is EVAR sometimes difficult for abdominal aortic aneurysms?

EVAR eligibility can be limited by anatomical constraints such as narrow, tortuous, or angulated iliac arteries, which increase the risk of access-vessel injury during the procedure.

Q: What study design and patient numbers were used to compare Altura® LPSG and standard-profile stent grafts?

The study was a single-center retrospective case-matched design, including 30 patients treated with Altura® low-profile stent grafts and 30 matched controls treated with standard-profile stent grafts.

Sep 30, 2026

Uploaded by mieayamfan

Endovascular aneurysm repair (EVAR) is preferred for abdominal aortic aneurysms, but narrow or tortuous iliac anatomy can limit eligibility. This single-center retrospective case-matched study compared Altura® low-profile stent grafts (LPSG) versus standard-profile stent grafts (SPSG) in 30 Altura® patients matched to 30 controls between July 2021 and February 2023. LPSG recipients more often had narrow access vessels, with shorter procedure time and reduced hospital stay. No 30-day mortality or 12-month aneurysm-related rupture, infection, or death was observed; secondary intervention rates were similar. Conclusions support LPSG safety and efficacy, especially in challenging anatomy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

1. Introduction

2. Materials and Methods

2.1. Setting and Design

2.2. Patients

Article Low-Profile Altura® Endograft System Versus Standard-Profile Stent Grafts for Endovascular Aneurysm Repair: A Case-Matched Study Marek Piwowarczyk 1, Mateusz Rubinkiewicz 2, Jerzy Krzywo ´n 1, Roger M. Krzyewski 3, Jeremy Jan Spula 4, Hubert Kostka 4 and Katarzyna Zbierska-Rubinkiewicz 1, * Academic Editor: Karin Pfister Received: 30 October 2025 Revised: 7 December 2025 Accepted: 19 December 2025 Published: 30 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Vascular Surgery, University Hospital of Krakow, 30-688 Krakow, Poland; [mpiwowarczyk@su.krakow.pl](mpiwowarczyk@su.krakow.pl) (M.P.); [jkrzywon@gmail.com](jkrzywon@gmail.com) (J.K.) 2 2nd Department of General Surgery, Jagiellonian University, 31-007 Krakow, Poland; [mateusz.rubinkiewicz@uj.edu.pl](mateusz.rubinkiewicz@uj.edu.pl) 3 Department of Neurosurgery, Jagiellonian University, 31-007 Krakow, Poland; [roger.krzyzewski@uj.edu.pl](roger.krzyzewski@uj.edu.pl) [4](4 Faculty of Medicine)[ Faculty of Medicine](4 Faculty of Medicine), [Collegium Medicum](Collegium Medicum), [Jagiellonian University](Jagiellonian University), [31-008 Krak](31-008 Krak)ó[w](w), [Poland](Poland); [jeremyspula@gmail.com](jeremyspula@gmail.com) (J.J.S.); [h-kostka99@o2.pl](h-kostka99@o2.pl) (H.K.) * Correspondence: [zbierska.k@gmail.com](zbierska.k@gmail.com) Abstract Background/Objectives: Endovascular aneurysm repair (EVAR) is currently the preferred method for treating abdominal aortic aneurysms (AAA) due to lower perioperative morbidity and mortality compared with open aortic repair (OAR) . However, anatomical limitations such as narrow or tortuous iliac arteries may preclude EVAR. The low-profile Altura® stent graft (LPSG) was designed to overcome these limitations. This study aimed to compare the outcomes of Altura® low-profile endografts with standard-profile stent grafts (SPSGs) in AAA treatment. Methods: This single-center, retrospective, case-matched study included 30 patients treated with Altura® LPSG and 30 matched controls who underwent SPSG implantation between July 2021 and February 2023 . Demographic, anatomical, operative, and postoperative parameters were analyzed. Follow-up was performed at 3, 6, and 12 months using ultrasound and computed tomography angiography (CTA) . Results: Patients in the LPSG group more frequently had narrow access vessels (<6 mm, 46.7% vs. 3.3%, p = 0.001) . The mean procedure time was shorter in the LPSG group (80 vs. 90 min, p = 0.04), and hospital stay was reduced (3 vs. 4 days, p = 0.03) . No 30-day mortality occurred in either group. At 12 months, no aneurysm rupture, graft infection, or aneurysmrelated death was observed. The rate of secondary interventions was comparable between groups. Conclusions: The low-profile Altura® stent graft provides a safe and effective option for AAA patients with narrow access vessels. Its bilateral parallel configuration and lack of gate cannulation simplify EVAR, shorten procedure time, and may be especially beneficial in emergency or anatomically challenging cases. Further prospective studies are warranted to confirm these findings. Keywords: endovascular aneurysm repair; abdominal aortic aneurysm; low-profilestent graft 1. Introduction Endovascular aneurysm repair (EVAR) has proved to be superior to open aortic repair (OAR) in early morbidity and mortality in patients with infrarenal abdominal aortic aneurysms (AAAs) [1,2] . Nowadays, more than three-quarters of patients in the United States and some European countries are treated with EVAR for unruptured AAA [3,4] . However, not all patients are eligible for EVAR due to anatomical requirements. EVAR applicability is limited in patients with difficult iliofemoral vascular access, including angulated, tortuous, or narrow iliac arter

FAQs

Why is EVAR sometimes difficult for abdominal aortic aneurysms?

EVAR eligibility can be limited by anatomical constraints such as narrow, tortuous, or angulated iliac arteries, which increase the risk of access-vessel injury during the procedure.

What study design and patient numbers were used to compare Altura® LPSG and standard-profile stent grafts?

The study was a single-center retrospective case-matched design, including 30 patients treated with Altura® low-profile stent grafts and 30 matched controls treated with standard-profile stent grafts.

What were the main perioperative outcome differences between the LPSG and SPSG groups?

Patients in the LPSG group more frequently had narrow access vessels. The mean procedure time was shorter and hospital stay was reduced in the LPSG group, while 30-day mortality was not observed in either group.

Sep 30, 2026

Uploaded by mieayamfan