Mid-term fixation stability of the EndoVascular Technologies endograft. EVT Investigators.
OBJECTIVE
to determine the positional stability of the EndoVascular Technologies (EVT) endograft after endovascular aneurysm repair during morphologic changes of the abdominal aorta during follow-up.


METHODS
all patients treated worldwide with an EVT endograft with an adequate postoperative and at least 12 months postoperative CT scan were included (n=125). Endograft migration was investigated by recording the position of the endograft attachment systems relative to the renal arteries and the aortic or iliac bifurcations. The vertical body axis served as a scale to quantify migration. Aortic cross-sectional areas were measured in the suprarenal aorta and in the proximal and distal aneurysm necks. Length changes of the infrarenal aorta during follow-up were measured, comparing the distance between the left renal artery and the aortic bifurcation.


RESULTS
the median follow-up was 24 months (range 12-48 months). Graft migration was identified in 4 out of 125 patients (3%). Significant infrarenal aortic dilation was observed at the proximal and distal aneurysm neck during follow-up. However, aortic neck dilation was not associated with endograft migration. The length of the infrarenal aorta did not change significantly after endovascular repair.


CONCLUSIONS
fixation by stents containing hooks of the EVT design appear to be effective in preventing migration of endografts with an unsupported trunk for up to four years. A stable position was maintained in spite of changes in cross-sectional areas of the aneurysm neck.
Broeders
I A
IA
Department of Vascular Surgery GO4.232, University Hospital Utrecht, Heidelberglaan 100, 358 CX Utrecht, The Netherlands.
Blankensteijn
J D
JD
Wever
J J
JJ
Eikelboom
B C
BC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000592:standards*; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome