Clinical Performance and Safety Assessment of the Use of iCover Balloon Expandable Covered Stent (iVascular) Implanted as Bridging Stent in FEVAR (Fenestrated Endovascular Aortic Repair) for the Treatment of Complex Abdominal Aortic Aneurysms
iCover balloon-expandable covered peripheral stent system as bridging stent
iCover balloon-expandable covered peripheral stent system as bridging stent: This device will be used as bridging stent during FEVAR (fenestrated endovascular aortic repair) procedures.
Study summary
fenCo is a European multicentre, prospective study to evaluate the use of the iCover covered stents as bridging stents for reno-visceral target vessel during fEVAR for the treatment of complex abdominal aortic aneurysms.
Eligibility
Sex
ALL
Min age
55 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Patient suitable for treatment of a juxta, para-renal, suprarenal or thoracoabdominal aneurysm with a fenestrated endoprosthesis in accordance with current indications and guidelines for the management of abdominal aortic aneurysms (aneurysm \> 5 centimetres for women and \> 5.5 centimetres for men and/or growth \> 5 mm in 6 months or 1 centimetre in 1 year).
2. The fenestrated endograft must be designed in a way that positions the fenestrations directly in front of the orifice of the target vessel, ensuring that the distance between the fenestration and the orifice of the target vessel does not exceed 5 mm.
3. Anatomy and patient strictly in accordance with the Instructions For Use (IFU) of the fenestrated endograft chosen to be implanted:
1. Cook Medical: Zenith Fenestrated AAA Endovascular Graft
2. Terumo Aortic: TREO and Anaconda Fenestrated Stent Grafts
3. JOTEC (part of Artivion): E-xtra design engineering.
4. Additional iCover stent, if necessary, could be placed in the same target artery (2 iCovers stents max as bridging stent for each fenestration).
5. Landing zone in the target vessel of at least 10 mm.
6. Target arteries (renal arteries, superior mesenteric artery, celiac trunk) with a diameter between 5 and 10 mm.
7. Angulation of the aorta at the level of the target vessels \< 45 degrees.
8. No early significant branching from the target vessel with a potential risk of coverage and subsequent significant risk of target organ infarctions.
9. Age \> 55 years.
10. Patient having notified his consent to this study and willing to comply with specified follow-up evaluations at the specified times.
11. Patient affiliated to or benefiting from a social security system.
12. Patient with life expectancy \> 12 months.
Exclusion Criteria:
1. Patients contraindicated for anti-platelet therapy.
2. Patients with uncontrolled haematological disorders or heparin-induced thrombocytopenia.
3. Chronic or acute aortic dissection.
4. Patients refusing treatment.
5. Patients who are pregnant or wish to become pregnant.
6. Patients scheduled for major or life-saving surgery within 30 days of the fenestrated stent procedure.
7. Patients considered hemodynamically unstable or requiring emergency treatment.
8. Patients with severe arteriopathy leading to adverse outflow, which may impair bridging stent patency on the targeted artery.
9. Thrombus in the aortic sealing zone and target arteries with thickness \> to 3 mm.
10. Stenosis (\>50%) or occlusion of target arteries or distal disease resulting in poor iCover stent outflow.
11. Patients allergic to stent materials (L605) and/or PTFE.
12. Patients requiring a hybrid aortic technique with branches, semibranches or chimneys.
13. Patient who has been implanted with any stent type or brand other than iCover as a bridging stent in any target artery.
14. Patients with infectious/mycotic aneurysms.
15. Angulation between renal artery and aortic wall \< 30 degrees.
16. Patients with complex iliac accesses out the IFUs of the fenestrated endograft chosen to be implanted (COOK Medical / Terumo Aortic/Jotec-Artivion) with the iCover Bridging stent.
17. Patient is currently participating in another investigational drug or device study that has not completed the entire follow up period that may interfere with the results of this study.
18. Myocardial infarction or stroke within 3 months prior to the procedure.
19. Patients with an unstable angina pectoris or heart insufficiency NYHA 3 or 4.
20. Patients with ASA classification 5 or higher.
21. Patients with physician modified endografts or in situ laser FEVAR.
Primary outcome measure(s)
Bridging stent patency at 12-month visit — 12 months visit Defined as rate of stents with an absence of binary restenosis (≥ 50% stenosis) based on CT Angio at 12 months visit (+/-2 months).
Absence of target vessel instability between implantation and 12-month visit. — starting at implant day through the study completion, with an average of 12Months up to 14Months per window. Defined as rate of patients with an absence of target vessel instability described as a composite endpoint of any branch-related complication leading to: aneurysm rupture/ death/ occlusion/ component separation/ or reintervention to maintain branch patency or to treat a branch-related component separation or endoleak between implantation and 12 months visit (+/-2 months).
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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