Mid-term Results of the Anaconda Fenestrated Stent-Graft Proximal Sealing System in the Exclusion of Complex Abdominal Aortic Aneurysms

The proximal sealing system of the Anaconda fenestrated stent-graft's demonstrates encouraging mid-term performance, with a low incidence of type Ia EL observed over more than 2 years of follow-up. The PND related to stent-graft OS is common but generally stabilizes after the first year. Beyond this point, any progression should be attributed to the underlying aortic disease. In such cases, proximal extension of the sealing zone can be performed with satisfactory outcomes.Clinical ImpactThis study provides the first dedicated mid-term evaluation of the proximal sealing system of the Anaconda® fenestrated stent-graft in complex abdominal aortic aneurysms. When implanted in a healthy supraceliac landing zone with adequate effective oversizing, the device offers durable proximal sealing with a low incidence of type Ia endoleak. These findings support confident use of the Anaconda® platform in challenging anatomies, while emphasizing the importance of careful deployment to avoid use of the repositioning system and the associated risk of ring tilting. The study also highlights that early proximal neck dilatation is common but usually stabilizes, justifying tailored surveillance and allowing prophylactic proximal extension when necessary.