Observational studyCardiovascular and interventional radiology2025
Less Aortic Neck Dilatation of the ALTO Stent Graft compared to the Self-Expanding Stent Grafts after Endovascular Aortic Repair for Abdominal Aortic Aneurysms.
Observational study in Cardiovascular and interventional radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Re-intervention for type III endoleak after endovascular aneurysm repair with an ALTO stent graft: a case description.Quantitative imaging in medicine and surgery · 2026Article
- Four-Year Experience With the ALTO Stent Graft in Abdominal Aortic Aneurysms With Hostile Features.Cureus · 2025Article
Corrections and comments
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeProximal neck dilatation (PND) is a common issue after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs), being a potential cause of stent graft migration or type Ia endoleak. The ALTO stent graft, featuring a unique polymer sealing mechanism, has been reported to exhibit less PND. This study aims to compare PND and clinical outcomes between the ALTO stent graft and alternative self-expanding stent grafts.
methodsThe CustomSEAL study is a multi-center retrospective observational study involving 18 institutions in Japan. It compares EVAR outcomes using the ALTO stent graft and alternative self-expanding stent grafts for fusiform AAAs. The primary outcome measure was the difference in PND at 12 months post-EVAR. Secondary outcome measures included aneurysm sac diameter changes, reintervention rates, and mortality outcomes during the follow-up.
resultsAfter propensity score matching, 111 patient pairs were extracted. Baseline characteristics, including proximal neck length/diameter and stent graft oversizing, were comparable between groups. The ALTO stent graft was associated with significantly less PND at 12 months (2.3% vs. 26.7%, P < 0.001). There were no significant differences in perioperative outcomes, aneurysm sac diameter changes, reintervention rates, or overall survival between the groups.
conclusionsThe ALTO stent graft demonstrated significantly less PND at 12 months post-EVAR compared to alternative self-expanding stent grafts, highlighting its potential advantage in exerting less chronic expanding force on the proximal aortic neck. Long-term follow-up is needed to validate the clinical benefits of the ALTO stent graft over the alternative self-expanding stent grafts. LEVEL OF EVIDENCE: Non-randomized controlled cohort/follow-up study.
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