Lateral Movement of Endografts within the Aneurysm Sac is an Indicator of Stent-Graft Instability

Purpose: To determine if lateral movement of an aortic endograft 1 year following endovascular abdominal aortic aneurysm (AAA) repair is an indicator of endograft instability and can serve as a predictor of late adverse events. Methods: The records of 60 high-risk AAA patients (52 men, 8 women; mean...

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Veröffentlicht in:Journal of endovascular therapy 2008-06, Vol.15 (3), p.335-343
Hauptverfasser: Rafii, Benjamin Y., Abilez, Oscar J., Benharash, Peyman, Zarins, Christopher K.
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Sprache:eng
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Zusammenfassung:Purpose: To determine if lateral movement of an aortic endograft 1 year following endovascular abdominal aortic aneurysm (AAA) repair is an indicator of endograft instability and can serve as a predictor of late adverse events. Methods: The records of 60 high-risk AAA patients (52 men, 8 women; mean age 74 years) who were treated with infrarenal (n=38) or suprarenal (n=22) endografts and had serial computed tomograms (CT) over ≥12 months were analyzed. Postimplantation and 1-year CT scans were compared, and changes in endograft position within the aneurysm sac [lateral movement (LM) versus no lateral movement (NM)] were measured using a vertebral body reference point. Longitudinal endograft movement was measured with respect to the superior mesenteric artery along the aortic centerline axis. Long-term adverse event rates (endoleaks, secondary procedures, conversion, rupture, and death) were assessed. Results: One year after endograft implantation, LM ≥5 mm was present in 16 (27%) patients; 44 (73%) endografts demonstrated no lateral movement. LM patients had larger aneurysms (6.5±1.5 versus 5.6±0.9 cm, p=0.02) and a longer endograft—to—hypogastric artery length (p=0.01) than NM patients. There were no significant differences between patients treated with infrarenal and suprarenal endografts. At 1 year, longitudinal migration ≥10 mm occurred in 5 (31%) of the LM patients versus 2 (5%) in the NM cohort (p
ISSN:1526-6028
1545-1550
DOI:10.1583/08-2422.1