Inaccurate aortic stent graft deployment in the distal landing zone: incidence, reasons and consequences†

Berezowski, Mikołaj; Morlock, Julia; Beyersdorf, Friedhelm; Jasiński, Marek; Płonek, Tomasz; Siepe, Matthias; Czerny, Martin; Rylski, Bartosz

doi:10.1093/ejcts/ezx379

Cited by 30 publications

(46 citation statements)

References 17 publications

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“…After the 23 full-text papers were read for eligibility, 10 additional studies were removed because eight studies did not include measurement of endograft position relative to an anatomical landmark or endograft apposition with the arterial vessel wall, one study measured these parameters from 2D digital subtraction angiography images, and one study reported measurements on fewer than 10 patients. The remaining 13 studies were included in this review [4][5][6][7][8][13][14][15][16][17][18][19][20]. A flowchart of the selection procedure is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies assessed the endograft in the proximal landing zone in the aortic neck after EVAR [8,14,17,19,20], three studies assessed the distal landing zone in the common iliac arteries (CIAs) after EVAR [6,7,16], and three studies assessed proximal and distal landing zones [4,5,15]. One study assessed the proximal landing zone after TEVAR [13], and one assessed the distal landing zone after TEVAR [18].…”

Section: Resultsmentioning

confidence: 99%

“…Precision of the measurements has only been validated for the distance between the distal edge of the endograft limb and the iliac artery bifurcation [7]. The method has been used to assess proximal endograft apposition in the aortic neck [4,5,14,15,19], proximal endograft position in the aortic neck relative to the lowest renal artery [4,5] or relative to the superior mesenteric artery (SMA) [15], distal endograft apposition in the CIAs [4][5][6][7]15,16], distal endograft limb position in the CIAs relative to the iliac bifurcation [6,7,15,16], proximal position of the thoracic endograft relative to the left subclavian artery (LSA) [13], and distal position of the thoracic endograft relative to the celiac trunk [18]. • Method B determines the distance over the arterial wall between two 3D coordinates that are located on the arterial wall ( Figure 2(b)).…”

Section: Measurement Methodsmentioning

confidence: 99%

“…Two cohort studies were designed to compare patients with or without exposure to insufficient proximal or distal apposition (<10 mm) after EVAR [4,5], and one cohort study was designed to compare patients with or without exposure to inaccurate landing in the distal landing zone (>5 mm) after TEVAR (Supplementary Table 1) [18]. Risk of bias for selection was low (mean score, 3.7 of 4) but was high for comparability (mean score, 0.7 of 2) and for outcome (mean score, 1.3 of 3).…”

Section: Quality Assessmentmentioning

confidence: 99%

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A systematic review of standardized methods for assessment of endograft sealing on computed tomography angiography post-endovascular aortic repair, and its influence on endograft-associated complications

Schuurmann

Rooy

Gonçalves³

et al. 2019

Expert Review of Medical Devices

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Introduction: Although there is much attention for proper sizing of pre-operative anatomy before (thoracic) endovascular aneurysm repair ([T]EVAR), standardized assessment of endograft position and apposition at postoperative imaging is seldom addressed in the international guidelines. The highly detailed three-dimensional computed tomography angiography (CTA) volumes contain valuable information about the apposition of the endograft with the arterial wall and the position of the device relative to anatomical landmarks in the proximal and distal landing zones, which is currently hardly used. With proper assessment on CTA of the endograft after EVAR, the risk for future endograft-related complications may be determined, allowing patient-tailored, risk-stratified surveillance. Areas covered: This systematic review identified three standardized methods for assessing apposition or position of the endograft in the proximal or distal landing zone on CTA after (T)EVAR. Quantification of apposition and position, validation of measurement precision, and association with endograft-related complications were extracted. Short (<10 mm apposition length) and decreasing (>0 mm) apposition were associated with endograft-associated complications. Expert commentary: Standardized assessment of apposition and position of the endograft in the proximal and distal landing zones on CTA should be incorporated in post-(T)EVAR surveillance. A riskstratified CTA surveillance protocol is proposed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Measurement Methodsmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of standardized methods for assessment of endograft sealing on computed tomography angiography post-endovascular aortic repair, and its influence on endograft-associated complications

Schuurmann

Rooy

Gonçalves³

et al. 2019

Expert Review of Medical Devices

View full text Add to dashboard Cite

show abstract

“…Berezowski et al analysed the accuracy of landing in the distal landing zone in patients with a short distal landing zone. 2 Of 59 patients, they managed to deploy the stent graft accurately in the distal landing zone in just 10 (16.9%) patients. Precise landing was defined as a distance to the target vessel 5 mm.…”

mentioning

confidence: 99%