Concerns for the durability of the proximal abdominal aortic aneurysm endograft fixation from a 2-year and 3-year longitudinal computed tomography angiography study

Prinssen, Monique; Wever, Jan J.; Mali, Willem P.Th.M.; Eikelboom, B.C.; Blankensteijn, Jan D.

doi:10.1067/mva.2001.111682

Cited by 85 publications

(80 citation statements)

References 10 publications

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“…Others reported similar results and raised similar concerns. 2,[7][8][9]12,17 Our results expand on these findings and concerns. In our series, the procedural time and blood loss as well as the perioperative death rate (8.5%) were higher than in most other reports.…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Increasing Incidence of Midterm and Long-Term Complications After Endovascular Graft Repair of Abdominal Aortic Aneurysms: A Note of Caution Based on a 9-Year Experience

et al. 2001

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Section: Discussionsupporting

confidence: 77%

“…Similar concerns have also been raised by others. 2,[7][8][9]12,17,18 In the present study, we analyzed the durability and late complications after EVG repair of AAAs at our institution, where we first used an EVG to treat an AAA in November 1992. 19 …”

Section: Resultsmentioning

confidence: 99%

Increasing Incidence of Midterm and Long-Term Complications After Endovascular Graft Repair of Abdominal Aortic Aneurysms: A Note of Caution Based on a 9-Year Experience

et al. 2001

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“…The suprarenal and infrarenal levels have already been defined [3,8,9,10]. The infrarenal neck dilatation occurs in 21-23% of patients 2-3 years after treatment [8,9], whereas the suprarenal neck enlargement seems to be less frequent [3,5,11,12].…”

Section: Discussionmentioning

confidence: 98%

Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

et al. 2003

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The aim of this study was to evaluate incidence, potential risk factors and effects on stent-graft migration of proximal neck dilatation after endoluminal repair of abdominal aortic aneurysm (EVAR), and the role of ultrasound (US) in detecting neck enlargement. From November 1998 to October 2001, 90 patients underwent EVAR. On follow-up, US and CT angiography (CTA) were performed, and diameters of the suprarenal and infrarenal aortic necks were monitored. Incidence of significant neck enlargement (> or =2.5 mm) and distal stent-graft migration (>10 mm) was calculated. Several factors were evaluated as predictive of neck enlargement. Ultrasound and CTA measurements were compared. The US and CTA examinations were available in 68, 39, and 11 patients at 1, 2, and 3 years follow-up (mean follow-up 15 months). Incidence of significant neck dilatation was 21.8% at the infrarenal level (13, 33, and 36% at 1, 2, and 3 years follow-up) and 13.8% at the suprarenal level (9, 18, and 27% at 1, 2, and 3 years follow-up). Significant stent-graft migration occurred in 14 of 87 patients (16%) and was associated with neck dilatation in 8 (2 suprarenal and 6 infrarenal). No risk factors were identified. Ultrasound was less accurate than CT in measuring neck diameter, in particular at the suprarenal level. Proximal aortic neck enlargement occurs in up to 30% of patients after EVAR and represents the main risk factor for stent-graft migration. The risk of infrarenal neck dilatation is higher at 2 years follow-up, whereas the suprarenal neck enlarges later. Ultrasound is not useful in monitoring neck diameter.

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“…Thus, many authors have shown that oversizing is positively correlated with neck dilatation [25,28,31,33,[36][37][38].…”

Section: Biomechanics and Vessel Remodelingmentioning

confidence: 99%

Endograft Sizing for Abdominal Aortic Aneurysms

Sher¹,

Tadros²

2017

Aortic Aneurysm

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While a tight seal and fixation of aortic stent-grafts to the vessel wall are vital for positive outcomes in treating abdominal aortic aneurysms (AAAs), optimal aortic stent-graft sizing for endovascular aneurysm repair (EVAR) remains debatable. We performed a holistic review of the data surrounding the sizing of endografts using instructions for use (IFU) guidelines, as well as experimental, computational, and clinical studies. Most clinical studies that have investigated the role of sizing and outcomes are limited by the strict selection criteria, or the inability to account for the multitude of confounders associated with sizing. Currently, oversizing of endografts between 10 and 20% remains safe and favored, but sizing outside the IFU guidelines frequently occurs. Oversizing up to 25% appears to be associated with decreased rates of proximal endoleak and aneurysm sac enlargement, while excessive oversizing (>30%) has been linked to graft infolding, collapse, and aortic dilatation. It is unclear, however, whether there is an association between oversizing associated with neck dilatation and graft migration. During sizing, surgeons should take an individual approach and consider several factors including device type, calcification and/or thrombus of apposition site, hemodynamics, and aortoiliac morphology.

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Concerns for the durability of the proximal abdominal aortic aneurysm endograft fixation from a 2-year and 3-year longitudinal computed tomography angiography study

Cited by 85 publications

References 10 publications

Increasing Incidence of Midterm and Long-Term Complications After Endovascular Graft Repair of Abdominal Aortic Aneurysms: A Note of Caution Based on a 9-Year Experience

Increasing Incidence of Midterm and Long-Term Complications After Endovascular Graft Repair of Abdominal Aortic Aneurysms: A Note of Caution Based on a 9-Year Experience

Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

Endograft Sizing for Abdominal Aortic Aneurysms

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