Delayed Graft Dislocation After Thoracic Aortic Endovascular Repair

Piffaretti, Gabriele; Negri, Silvia; Ferraro, Stefania; Bossi, Matteo; Rivolta, Nicola; Fontana, Federico; Castelli, Patrizio

doi:10.3126/kumj.v12i2.13653

Cited by 3 publications

(6 citation statements)

References 12 publications

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“…1,2 Although migration of thoracic grafts was specifically defined in 2010, 2 there is a lack of structural data reported from real-life registries regarding late migration. 3,4 The purpose of this study was therefore to describe the incidence and timing of stent graft migration and to identify potential risk factors for migration to allow further optimization of a follow-up protocol after TEVAR.…”

mentioning

confidence: 99%

Endograft migration after thoracic endovascular aortic repair

Geisbüsch

Skrypnik

Ante

et al. 2019

Journal of Vascular Surgery

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confidence: 99%

Endograft migration after thoracic endovascular aortic repair

Geisbüsch

Skrypnik

Ante

et al. 2019

Journal of Vascular Surgery

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“…However, these rates were observed with first-generation devices, different methods of assessment of endograft position, and diverse definitions of EM. 6,22,23 After publishing the definition of EM in 2010, trials using contemporary endografts reported improved TEVAR performance with EM rates up to 8%. 5,19,24 However, very few trials used the standard-based protocol of assessment of endograft position, which includes primary analysis of centerline distances between tips and covered parts of the endograft relative to large aortic branches and secondary analysis relative to anatomical landmarks (eg, calc, surgical clips, etc), when endograft movement >10 mm was suspected.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, literature and evidence on this clinically important topic remain limited. 5,6 The majority of related studies failed to analyze EM perstandard and reported heterogeneous EM rates using diverse assessment methods and definitions. Furthermore, reported EM-related reintervention and morbidity/mortality rates vary widely between studies.…”

Section: Introductionmentioning

confidence: 99%

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Late Endograft Migration After Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-analysis

et al. 2022

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Purpose: The objective of this systematic review was to report the cumulative incidence of endograft migration (EM), as well as the morbidity, reintervention rates, and mortality related to EM. This study aimed to provide evidence-based data on patient-relevant sequelae of EM after thoracic endovascular aortic repair (TEVAR) performed using contemporary aortic endografts. Materials and Methods: A systematic electronic search of literature in MEDLINE (via PubMed), Web of Science, and Cochrane Central Register of Controlled Trials was performed. The pooled synthesis of outcomes was performed using the inverse variance method. Results: Seven prospective non-randomized and 4 retrospective studies, including a total of 1783 patients presenting 70 EMs, were considered for the quantitative analysis. The pooled rate of EM was 4% (95% CI, 2%–7%; range, 0.2%–11%; I2=82%); pooled morbidity rate was 31% (95% CI, 12%–59%; range, 0%–100%; I2=64%) and pooled reintervention rate was 32% (95% CI, 15%–56%; range, 0%–100%; I2=55%). The pooled mortality rate due to EM was 5% (95% CI, 1%–21%; range, 0%–40%; I2=24%). Conclusion: For the first time, this meta-analysis provides pooled reference estimates of EM after TEVAR. Thus, the results hold the potential to further characterize EM after TEVAR. The clinical relevance of EM is underlined by its association with high rates of endoleak-related morbidity, reintervention, and mortality. Close standardized surveillance after TEVAR for early detection of EM and prophylaxis of its sequelae is essential.

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“…The early and late migration of the aortic stent graft is discussed previously. 3 4 5 Anatomic factors (e.g., type of aortic arch) and procedural factors (the type of proximal landing zone) can also influence the migration of stent grafts. However, there is not much evidence in the literature regarding the incidence and risk factors for stent-graft migration.…”

Section: Introductionmentioning

confidence: 99%

Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study

Deshpande

Pandey

Shaw

et al. 2022

Indian J Radiol Imaging

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Background Migration of the stent-graft post-thoracic endovascular aortic repair (TEVAR) is not uncommon; however, it is sparsely reported. The objective of this study was to assess the incidence, risk factors, and complications of stent-graft migration post-TEVAR. Materials and Methods Thirty-one patients who underwent TEVAR were retrospectively analyzed. The demographic, anatomical, and procedure-related factors were assessed. The measurements were done along the greater curvature of aorta around two fixed anatomic landmarks, that is, left common carotid artery or neoinnominate artery (hybrid repair) proximally and celiac artery distally. Aortic elongation and migration at proximal, distal, as well as at overlapping zone were measured. More than 10 mm of migration was considered significant. Results Significant migration was observed in six (19%) patients. No significant migration was observed in the overlapping zone. The proximal landing zone 3 (odds ratio [OR] 12.78, p 0.01) was a significant risk factor, whereas landing zone 2 was a protective factor against the migration (OR 0.08, p 0.02). The odds for migration were more in segments I/3 and II/3 compared with I/2 and II/2, respectively, as per Modified Arch Landing Areas Nomenclature. A single complication was seen in the migration group which was treated by an overlapping stent graft. Conclusion The stent-graft migration after TEVAR is not uncommon. Type 3 proximal landing zone was a significant risk factor for migration with an increased risk toward I/3 and II/3. Proximal landing zone 2 as well as adequate overlapping distance in multiple stent grafts can prevent migration. Ethical Approval No IECPG-227/24.06.2020

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Delayed Graft Dislocation After Thoracic Aortic Endovascular Repair

Abstract: Background

Cited by 3 publications

References 12 publications

Endograft migration after thoracic endovascular aortic repair

Endograft migration after thoracic endovascular aortic repair

Late Endograft Migration After Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-analysis

Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study

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