当前位置： SCI文献检索 > JOURNAL OF VASCULAR SURGERY期刊下所有文献 > Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: a cautionary note.

Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: a cautionary note.

Abstract：

BACKGROUND:Positional stability of the endograft is essential for long-term durability after endovascular abdominal aortic aneurysm repair (EAR). However, the cumulative risk of delayed endograft migration has been sparsely reported. METHOD:A total of 91 patients studied underwent EAR with the AneuRx endograft with a minimum 1 year from implantation. Data from a prospective database were assessed for proximal endograft migration, defined as > or = 5 mm change from the initial endograft position. Multiple anatomic characteristics were also examined. Sixty-nine patients were alive, with complete follow-up at 1 year, with a mean time from implantation of 33.2 +/- 1.1 months. Data are mean +/- SEM. RESULTS:Endograft migration occurred in 15 patients, giving a cumulative event rate of 7.2% (5/69) at 1 year, 20.4% (10/49) at 2 years, 42.1% (8/19) at 3 years, and 66.7% (2/3) at 4 years post-EAR (P =.01). Although the initial aortic neck diameter did not differ between the groups (21.5 +/- 0.6 mm vs 21.8 +/- 0.3 mm, P =.61), significant (P <.05), late aortic neck enlargement was seen in patients with migration (25.0 +/- 1.6 mm, 26.2 +/- 1.2 mm, and 27.0 +/- 1.0 mm at 1,2, and 3 years, respectively) but not in nonmigrators. Regression analysis demonstrated a statistically significant (P <.05) correlation between endograft oversizing and late aortic neck dilation. Overall migration risk was 29.2% in patients oversized >20% and 18.6% in patients oversized < or = 20%. Aortic neck angulation (23.4 +/- 6.6 degrees vs 23.5 +/- 3.3 degrees, P =.99), aortic neck length (25.9 +/- 2.5 mm vs 27.0 +/- 1.6 mm, P =.74), initial endograft/aortic neck overlap (18.6 +/- 2.6 mm vs 19.4 +/- 1.4 mm, P =.80) and size of abdominal aortic aneurysm (55.5 +/- 1.5 mm vs 54.9 +/- 1.4 mm, P =.84) were similar between migrators and nonmigrators, respectively. Secondary endovascular treatment with aortic cuffs was required in five patients with device migration. CONCLUSIONS:Device migration after EAR with the AneuRx endograft occurred with significant frequency, the incidence of which increased with the length of follow-up. Late aortic neck dilation was significantly associated with migration. Oversizing of the endograft of >20% may accelerate this late aortic neck dilation. However, the etiologies of endograft migration were likely multifactorial, as the majority (8/15) of patients experiencing migration were oversized <20%. Although endovascular repair of these migrations is usually possible, the long-term durability of these secondary procedures is unknown. Careful surveillance for this endograft failure mode must be an essential component of post-EAR follow-up.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Conners MS 3rd,Sternbergh WC 3rd,Carter G,Tonnessen BH,Yoselevitz M,Money SR

doi

10.1067/mva.2002.126561

subject

Has Abstract

pub_date

2002-09-01 00:00:00

pages

476-84

issue

eissn

0741-5214

issn

1097-6809

pii

S0741521402000812

journal_volume

pub_type

杂志文章

在线工具

Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: a cautionary note.