Longitudinal aneurysm shrinkage following endovascular aortic aneurysm repair: A source of intermediate and late complications

Citation
P. Harris et al., Longitudinal aneurysm shrinkage following endovascular aortic aneurysm repair: A source of intermediate and late complications, J ENDOVAS S, 6(1), 1999, pp. 11-16
Citations number
16
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF ENDOVASCULAR SURGERY
ISSN journal
1074-6218 → ACNP
Volume
6
Issue
1
Year of publication
1999
Pages
11 - 16
Database
ISI
SICI code
1074-6218(199902)6:1<11:LASFEA>2.0.ZU;2-6
Abstract
Purpose: To report the incidence of delayed com plications following endova scular abdominal aortic aneurysm (AAA) repair and the relationship of these sequelae to morphological changes in the sac and endograft. Methods:Twenty-six AAA patients treated with Vanguard endografts had comple ted greater than or equal to 1-year follow-up. Postoperative angiograms and spiral computed tomographic (CT) scans with 3-dimensional reconstruction w ere compared to the 1-year images to determine morphological changes in the aneurysm sac a nd the endograft. These changes were then related to compli cations occurring between 1 and 12 months postoperatively in the study grou p. Results: Comparison of angiograms uncovered endograft buckling in 18 (69%) patients and acutely angled or kinked endografts in 10 (38%). Measurements from the CT scans found that undistorted endografts had a mean change in sa c length of +6.6 mm. Mean sac length change in buckled endografts was -3.1 mm, while kinked endografts displayed a mean change of -6.2 mm (p < 0.002, Student's t-test). Five (19%) patients, all with distorted endografts, demo nstrated late (1 to 12 months) complications (4 endoleaks and 1 graft limb thrombosis) owing to component separation, distal stent migration, and acut e angulation. No movement in the proximal stent was observed. Elongation of the endograft (flow line measurement) was observed in one tube graft only. Conclusions: In this study, longitudinal shrinkage of the sac following end ovascular aortic aneurysm repair led to buckling or kinking of the endograf t within 1 year in 69% of patients. This appears to be an important source of delayed complications.