Vascular Endostapling Systems for Vascular Endografts (T)EVAR-Systematic Review-Current State

Purpose: Recently, vascular endostapling systems were developed to achieve better sealing at the proximal neck of the aneurysm and to prevent endograft migration. The purpose of this study was to provide a systematic review about the current state and possible options of vascular endostapling systems. Results: No randomized controlled trials were published. The results showed that the use of an endostaple system considerably reduced the rates of endoleaks type 1a and endograft migration. Regarding the use of endostaples in different types of endografts, only a few results were available. Conclusion: The results are not conclusive. With endostaple systems, patients with difficult anatomic features and high risk can potentially be treated. These systems might reduce the high reintervention rates after endovascular aneurysm repair. Controlled randomized trials with larger number of patients are warranted with endostapling use in primary endograft implantation and for use in reintervention for late endoleaks or endograft migrations.