{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:49:25Z","timestamp":1765212565933,"version":"3.46.0"},"reference-count":31,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: Endovascular aneurysm repair (EVAR) using Aorfix (Lombard Medical, Inc., Irvine, CA, USA)TM has shown excellent outcomes, even in cases of abdominal aortic aneurysm with highly angulated aortic necks (\u226560\u00b0). However, long-term outcomes for Japanese patients remain unknown. In this study, we aimed to investigate the performance of AorfixTM in Japanese patients with highly angulated aortic necks. Methods: Among 114 patients in whom AorfixTM was used for EVAR at a single institution from October 2014 to October 2021, 105 patients without rupture or infection were retrospectively reviewed. They were classified into the following two groups: those with proximal neck angulations of \u226560\u00b0 and &lt;60\u00b0. Endpoints included technical success, long-term survival, freedom from aneurysm-related mortality, and freedom from reintervention. Results: Among 105 cases reviewed, 54 and 51 had proximal neck angulations of &lt;60\u00b0 and \u226560\u00b0, respectively. The &lt;60\u00b0 and \u226560\u00b0 groups had a mean neck angulation of 30.7\u00b0 (median 30\u00b0, range 10\u201356\u00b0) and 80.3\u00b0 (median 77\u00b0, range 60\u2013110\u00b0), respectively. The \u226560\u00b0 group had significantly increased operation time (p = 0.034), volume of contrast agent used during the operation (p = 0.0301), and duration of fluoroscopy during the operation (p &lt; 0.0001); however, the rates of additional renal artery stenting, cuff placement, and access site complications did not differ between the groups. There were also no differences in the incidence of aneurysm enlargements, secondary intervention, and endoleaks incidence. Conclusions: EVAR with AorfixTM achieved satisfactory results in Japanese patients with severe and mild\/moderate proximal neck angulation.<\/jats:p>","DOI":"10.3390\/jcm14248617","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8617","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes of the Aorfix\u2122 Stent Graft in Japanese Patients with Severely Angulated Aortic Necks: A Single-Center Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Riha","family":"Shimizu","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Saitama Prefectural Cardiovascular and Respiratory Center, 1696, Itai, Kumagaya 360-0197, Saitama, Japan"},{"name":"Department of Cardiac and Vascular Surgery, Dokkyo Medical University Nikko Medical Center, 145-1, Moritomo, Nikko 321-1298, Tochigi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Sumi","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Saitama Prefectural Cardiovascular and Respiratory Center, 1696, Itai, Kumagaya 360-0197, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8754-5913","authenticated-orcid":false,"given":"Yuri","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Saitama Prefectural Cardiovascular and Respiratory Center, 1696, Itai, Kumagaya 360-0197, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Saitama Prefectural Cardiovascular and Respiratory Center, 1696, Itai, Kumagaya 360-0197, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Ohki","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, 3-19-18, Nishishinbashi, Minato-ku, Tokyo 105-8471, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"United Kingdom EVAR Trial Investigators, Greenhalgh, R.M., Brown, L.C., Powell, J.T., Thompson, S.G., Epstein, D., and Sculpher, M.J. 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