Size of the Proximal Neck in AAAs Treated With Balloon-Expandable Stent-Grafts: CTA Findings in Mid- to Long-term Follow-up

Peirano, Miguel; Bertoni, Hernán G.; Chikiar, Darío S.; Martínez, Jorge M.P.; Girella, Germán A.; Barone, Héctor D.; Guzman, Randolph; Douville, Yvan; Yin, Tieying; Nutley, Mark; Zhang, Ze; Guidoin, Robert

doi:10.1583/09-2711.1

Cited by 12 publications

(16 citation statements)

References 47 publications

(74 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study, like others before it4-11 demonstrated a high incidence of neck dilatation following EVAR with a self-expanding stent graft. We observed some degree of neck dilatation at the 4-year follow-up in all cases.…”

Section: Discussionsupporting

confidence: 86%

“…Several authors have described medium-term changes in aneurysm neck diameter after EVAR using a variety of stent grafts 4-11. These studies tended to treat neck dilatation as an all or nothing phenomenon, and focused on its incidence in varying assortments of device types.…”

Section: Introductionmentioning

confidence: 99%

“…These studies tended to treat neck dilatation as an all or nothing phenomenon, and focused on its incidence in varying assortments of device types. The only long-term, device-specific data relate to the behavior of a balloon-expanded stent graft, which appears to produce a very low rate of neck dilatation 11. The other studies suggest that following the implantation of a self-expanding stent graft, neck dilatation would continue to proceed relentlessly with an ever-increasing rate of serious complications, especially in the absence of active fixation 6-9.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term follow-up of neck expansion after endovascular aortic aneurysm repair

Monahan

Chuter

Reilly

et al. 2010

Journal of Vascular Surgery

View full text Add to dashboard Cite

Objective To determine the rate, extent and clinical significance of neck dilatation after endovascular aneurysm repair (EVAR). Methods Patients who underwent elective EVAR using bifurcated Zenith (Cook, Bloomington, IN) stent-grafts and had at least 48-months of clinical and radiographic follow-up were included in the present study. Computed tomographic images were analyzed on a 3-dimensional workstation (TeraRecon, San Mateo, CA). Neck diameter was measured 10 mm below the most inferior renal artery, in planes orthogonal to the aorta. Nominal stent graft diameter was obtained from implantation records. Results 46 patients met the inclusion criteria. Median follow-up was 59 months (range 48-120 months). Neck dilation occurred in all 46 cases. The rate of neck dilation was greatest at early follow-up intervals. At 48-months, median neck dilation was 5.3 mm (range 2.3-9.8 mm). The extent of neck dilation at 48-months correlated with percentage of stent-graft oversizing (Spearman’s rho 0.61, p<0.001). There were no cases of type I endoleak or migration (> 5 mm). Conclusions Following EVAR with the Zenith stent-graft, the neck dilates until its diameter approximates the diameter of the stent-graft. Neck dilation was not associated with type I endoleak or migration of the stent-graft.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term follow-up of neck expansion after endovascular aortic aneurysm repair

Monahan

Chuter

Reilly

et al. 2010

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…4,24 Stent-graft migration and neck dilatation seem not to be problems for patients treated with balloon-expandable grafts. 25,26 Self-expanding stent-grafts, however, must be oversized to get enough radial force for proximal fixation. Balloon-expandable stent-grafts are dilated to the maximal diameter, so the Palmaz stent component will maintain its diameter without further force.…”

Section: Discussionmentioning

confidence: 99%

Influence of Different Self-Expanding Stent-Graft Types on Remodeling of the Aortic Neck After Endovascular Aneurysm Repair

Oberhuber¹,

Schwarz²,

Hoffmann³

et al. 2010

Journal of Endovascular Therapy

View full text Add to dashboard Cite

show abstract

“…In a recent comparative study by Savlovskis et al, repair with certain type of self-expandable stent (SES)—endografts (Nellix; Endologix, Irvine, CA, USA) caused progressive infrarenal aortic neck enlargement although repair with BES endografts did not cause any neck enlargement after a 24–34 months follow-up (34). Additionally, Peirano et al showed that the diameter reached at initial deployment did not increase further in the long term, which supports the safety and reliability of a modular BES graft and illustrates that this device does not produce dilatation of the proximal neck after deployment (35). However, data on BES grafts are heterogenous as most of the studies have used different types of BES grafts, and no concrete conclusions could be produced.…”

Section: Progression Of Proximal Aaa Neck After Evarmentioning

confidence: 91%

Proximal Aortic Neck Progression: Before and After Abdominal Aortic Aneurysm Treatment

et al. 2017

View full text Add to dashboard Cite

Several risk factors including short or highly angulated proximal aortic neck have been associated with long-term outcomes after endovascular or open abdominal aortic aneurysm (AAA) repair. However, research data have emerged recently concerning the behavior of proximal aortic neck, and several authors have tried to evaluate this behavior after endovascular or open repair. Additionally, computed tomography angiography (CTA) remains the golden standard for detecting and observing the morphology of an AAA, both before and after treatment. Moreover, the question of whether the proximal neck’s progression independently affects postoperative morbidity and reintervention risks still remains. Therefore, this focused review aims to present all relevant data on the behavior of an AAAs neck, based on CTA imaging before and after repair, in order to produce useful conclusions for future clinical practice.

show abstract

Size of the Proximal Neck in AAAs Treated With Balloon-Expandable Stent-Grafts: CTA Findings in Mid- to Long-term Follow-up

Cited by 12 publications

References 47 publications

Long-term follow-up of neck expansion after endovascular aortic aneurysm repair

Long-term follow-up of neck expansion after endovascular aortic aneurysm repair

Influence of Different Self-Expanding Stent-Graft Types on Remodeling of the Aortic Neck After Endovascular Aneurysm Repair

Proximal Aortic Neck Progression: Before and After Abdominal Aortic Aneurysm Treatment

Contact Info

Product

Resources

About