Device migration after endovascular abdominal aortic aneurysm repair: experience with a talent stent-graft.
OBJECTIVE
Device migration (DM) may cause late failure after endovascular aortic aneurysm repair (EVAR). Computed tomography (CT) scans following EVAR were reviewed to establish the frequency of DM and whether it can be predicted.


METHODS
Fifty-five patients underwent EVAR with a Talent stent-graft with suprarenal fixation. CT with a fixed protocol was performed at regular intervals. Patient demographics, risk factors, procedure details, and follow-up events were reviewed. Two observers, blinded to each other, reviewed axial images and mutliplanar reformats of the CT scans. DM was defined as a change of > or = 10 mm in the distance between a reference vessel (celiac axis/superior mesenteric artery) and the proximal device. Follow-up was performed for a minimum of 2 years (mean, 3 years; range, 2-5 years).


RESULTS
DM was detected in six of 38 patients (15.8%) by 2 years. There were no new cases of migration in the 19 patients at 3 years but one new case in the six patients at 4 years (16.6%). Mean migration over 2 years was 4.8 mm +/- 4.2 mm. One patient with DM developed a type I endoleak that required reintervention. This patient developed a further endoleak and died following surgery for rupture. Top neck enlargement was the only predictive factor identified, present in 71% of patients with DM (P = .056).


CONCLUSIONS
DM occurred in a small proportion of patients; closer follow-up intervals may be necessary in patients with short/enlarging proximal necks.
England
Andrew
A
Department of Radiology, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester, UK. andrew.england@smtr.nhs.uk
Butterfield
John S
JS
Jones
Nick
N
McCollum
Charles N
CN
Nasim
Akhtar
A
Welch
Mark
M
Ashleigh
Raymond J
RJ
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D016009:Chi-Square Distribution; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome