Nature, frequency, and predictors of secondary procedures after endovascular repair of abdominal aortic aneurysm

Abstract

Current endovascular devices are associated with a relatively high rate of complications over mid-term follow-up, culminating in frequent need for secondary remedial procedures. With strict follow-up imaging compliance, however, risk for rupture and aneurysm-related death remain exceedingly low. Newer technology may achieve improved durability and a lower requirement for secondary procedures, while maintaining the minimally invasive nature of presently available devices.

Effect of Curvature on Displacement Forces Acting on Aortic Endografts: A 3-Dimensional Computational Analysis

“…[4][5][6] Failure of fixation can lead to device migration and adverse clinical events, such as secondary interventions, endoleaks, rupture and death. 7 A number of factors hypothesized to affect device migration have been clinically investigated, including aortic neck diameter, length, and angulation; neck calcification and thrombus; neck enlargement; inadequate proximal and distal fixation length; and neck enlargement. [8][9][10] In-vitro 11 and in-vivo experimental studies, 12 as well as theoretical 13 and computational studies, [14][15][16][17][18][19] have been conducted to investigate the magnitude of the loads acting on endografts.…”

Type II Endoleak Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm: Innovative Transgraft Approach to Contemporary Management

“…16,[27][28][29][30][31] Higher failure rates with femoral TAE compared to TLE (80% vs. 8%) are believed to be due to embolization of a single vessel and failure to completely obliterate the central nidus and the feeding vessel(s) in the first attempt. Of interest, comparable success rates (72% vs. 78%) have been reported 16,32 when both the feeding artery and endoleak cavity are embolized.…”

Reparación endovascular de Aneurisma aórtico abdominal: Estudio piloto de endoprótesis Ovation™. Resultados comparativos

“…Los componentes de la endoprótesis pueden presentar fatiga en el tiempo, perdiendo su capacidad de excluir el AAA, o el ensamble entre los componentes puede sufrir desconexión, lo que puede determinar la ruptura del AAA a pesar del tratamiento. Durante el seguimiento alejado de pacientes tratados por esta vía (4 a 8 años), entre un 6,2 y 31,9% de ellos presenta falla del sistema por alguna de estas causas, lo que obliga a una nueva intervención para corregirlo [2][3][4] . Las nuevas generaciones de endoprótesis buscan minimizar esta limitante, optimizando la estuctura del sistema de stent de fijación, el tipo de poliester empleado, miniaturizando hasta donde es posible el calibre del sistema introductor etc.…”