title: Stent-graft migration after endovascular repair of abdominal aortic aneurysm.
abstract: OBJECTIVE
  To report the incidence of graft migration in patients after endovascular repair of abdominal aortic aneurysms (AAA) and assess the significance of neck diameter changes in patients with and without suprarenal stent implantation.
  
  
  METHODS
  The medical records and imaging studies of 176 consecutive patients (175 men; median age 71 years, range 48-88) who had endovascular AAA repair with the Nottingham aortomonoiliac system were reviewed. The following parameters were recorded: preoperative neck diameter and length, presence of intraoperative and late graft migrations, time to onset of late migration, length of late migration, and neck diameter changes in patients with documented late graft migration. The patients were divided into 2 groups based on the placement of an endograft with or without suprarenal bare stent fixation. Median follow-up was 15 months (range 1-48).
  
  
  RESULTS
  There were 15 (8.5%) graft migrations (6 intraoperative and 9 late). Of those, 14 (10.9%) were in the 128-patient infrarenal fixation group and 1 (2.1%) in the 48-patient suprarenal stent group. Median neck diameters on preoperative and postoperative computed tomography scans in patients with late migration were 22.2 mm and 23.0 mm, respectively (p>0.05). The median time to graft migration was 14 months after the original operation (range 6-36).
  
  
  CONCLUSIONS
  Distal device migration occurred frequently with the Nottingham system. Late graft migration was not associated with neck enlargement. Endografts with a suprarenal stent may have a decreased incidence of graft migration.
authors.affiliation: Division of Vascular Surgery, Nottingham University Hospital, Nottingham, England, UK. kalliafa@otenet.gr
authors.forename: Stavros
authors.initials: S
authors.lastname: Kalliafas
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Albertini
authors.forename: Jan
authors.initials: J
authors.lastname: Macierewicz
authors.forename: Syed W
authors.initials: SW
authors.lastname: Yusuf
authors.forename: Simon C
authors.initials: SC
authors.lastname: Whitaker
authors.forename: Ian
authors.initials: I
authors.lastname: Davidson
authors.forename: Brian R
authors.initials: BR
authors.lastname: Hopkinson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D016019:Survival Analysis; D017211:Treatment Failure; D014656:Vascular Surgical Procedures / Q000295:instrumentation*