Purpose: New EVAR techniques have emerged to conquer the hostile neck, one recently described is by the Japanese Vascular surgeons is the reverse slider technique (RST). This is a technique we have embraced at Nepean hospital, Australia, to minimise type1a-endoleaks.
Material and Methods: We aim to describe the modified technique in this presentation, going through a step-by-step recount of how to deploy the endurant stent system with the RST and outcomes in this single unit. A retrospective review between 2020-2021 identified 9 patients that underwent RST using the Endurant Stents. 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 endoleak upon follow up.
Results: Out of the 9 RST patients 6 were Male and 3 Female. The average aneurysm size was 5.53cm. 4 patients (44%) having ectatic bulges in the neck, 2 (22%) with conical necks and 3 (33%) with angulated necks. 4 patients underwent ESAR and 5 an EVAR. 1 (11%) patient had a type I-endoleak upon completion of the case that spontaneously resolved upon follow up. Further there were 0 type I-endoleaks confirmed on follow up, reporting a success of 100%. Post operatively there were no identified complications or reinterventions.
Conclusions: This presentation guides you through the technique and highlights the merit of utilising the RST in patients with hostile neck anatomy. A technique that can be used in EVARs/ESARs without excluding further intervention if required.