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Adjunctive distal EndoAnchor deployment to reinforce iliac seal zones in patients with high-risk anatomy: Initial experience

Year: 2026

Type: article

Abstract: Although EndoAnchors are approved for proximal fixation during endovascular aortic repair (EVAR), their distal use remains investigational. This retrospective study evaluated the safety and feasibility of distal EndoAnchors in five patients with complex aortoiliac anatomy undergoing EVAR or chimney EVAR between 2020 and 2024. In addition to planned proximal fixation, anchors were deployed in the distal common iliac arteries to address complex anatomy or intraoperative type Ib endoleaks, using a specific fluoroscopic technique to protect the ureter. Distal fixation was technically successful in all cases and immediately resolved one intraoperative type Ib endoleak. No complications, such as ureteral or aortic injury, were observed, and follow-up imaging showed no evidence of type Ib endoleaks or graft migration. Preliminary results suggest distal EndoAnchor fixation may be a safe and feasible strategy for managing complex iliac sealing zones, although larger, long-term studies are needed to confirm durability.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2026.102245

Authors: Chun-Wei Liu, I-Hui Wu

Institutions: National Taiwan University Hospital, National Taiwan University

Language: English

Topic: Aortic aneurysm repair treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250