The PROTAGORAS Study

Konstantinos P. Donas, Giovanni Torsello

Department of Vascular Surgery

St. Franziskus Hospital Münster, Germany

Disclosure

Speaker name: .

Konstantinos Donas..............................................................................

I have the following potential conflicts of interest to report:

Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

Other(s)

I do not have any potential conflict of interest

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x

Chimney technique

• Current evidence base

Plethora of single-center series

Current evidence base

• Limited number of patients

• Wide variety of treated entities

• Several combinations of off-the-shelf devices

J Vasc Surg 2016

Devic

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128 patients with pararenal pathologies and the intention to treat by Endurant and Advanta V12 as chimney graft

The PROTAGORAS Study

D

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Sac regression: 64.8+/-14.6mm60.1+/-16.3mm, p <0.001

New onset of type IA endoleak: 1.6 %

The PROTAGORAS Study

Key findigs from the Protagoras Study

95.7% 93.3%

Reasons for good results in the PROTAGORAS study

1. Devices selection

3. Length of the new neck

2. Oversizing

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Importance of standard combinations

128 patients treated by Endurant

and balloon expandable chimney grafts

D

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Importance of standard combinations

41 patients treated by 10

different combinations between

abdominal and chimney grafts

D

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9 patients treated by 4 different combinations of abdominal and chimneygrafts

Importance of standard combinations

Importance of new neck length N

ew

neck

length

Neck length/seal zone changed from 4.7mm to

18.7mm

New

neck

length

Overs

izin

g

Overs

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Chimney EVAR performing with Endurant Aortic Endografts

Sufficient landing zone of 20mm

Oversizing 20-30%

Standard combination with balloon

expandable covered stents

The PROTAGORAS Study

Konstantinos P. Donas, Giovanni Torsello

Department of Vascular Surgery

St. Franziskus Hospital Münster, Germany