1Gurkirat Singh, 1Arvind Lee,

1Vascular Unit Nepean Hospital

Introduction(s):

The Reverse Slider Technique (RST) has been recently described as an option to successfully treat infrarenal aneurysms with hostile neck features. It utilises the unique advantages of the deployment mechanism of the Medtronic Endurant stent graft to minimise type1a leak. In this review we explore the technique and the short-term outcomes encountered in Nepean Hospital, Australia.

Material(s) and Method(s):

A review of the technique, explaining the deployment technique and a retrospective review of 9 patients that underwent the RST using the Endurant stent system in Nepean Hospital over a one-year period. All cases were identified at planning for the use of the technique with or without endoanchors. Neck characteristics for RST were identified as conical, short, ectatic and/or angulated necks. Primary outcomes were technical success, defined as the absence of a type 1a endoleak and the presence of an endoleak on follow up.

Result(s):

There were 6 Male and 3 Female patients. The average aneurysm size was 5.53cm. Neck length ranged from 11mm to 40mm. 4 patients (44%) had ectatic bulges in the neck, 2 (22%) had conical necks and 3 (33%) had angulated necks. 4 patients had Endosuture Aneurysm repair.

Of the 9 patients 1 patient had a typeIa endoleak upon completion of the case that spontaneously resolved. Upon follow up, there were no type I endoleaks confirmed on either US or CT, reporting a success of 100%. There were no identified complications or reinterventions, in any of the cases.

Conclusion(s):

This review highlights the value of the RST in patients with hostile neck anatomy. Long-term follow up will be required to ascertain the sustained benefit of the technique in reducing long term risk of reintervention.