Aortic neck dilatation and endograft migration are correlated with self-expanding endografts.
OBJECTIVE
To compare self-expanding and balloon-expandable stent-grafts in terms of aortic neck dilatation and endograft migration.


METHODS
Two-hundred and forty-two patients (178 men; mean age 68 years, range 56-91) underwent elective endovascular repair of abdominal aortic aneurysm. Two-hundred self-expanding (115 Excluder, 48 Endologix, 23 Vanguard, 10 Anaconda, and 4 Talent) and 42 balloon-expandable (Lifepath) endografts were used. All patients underwent contrast-enhanced computed tomography (CT) prior to the intervention, at 1, 3, and 6 months after the procedure, and annually thereafter. Comparison was made between the first and the last follow-up CT scans.


RESULTS
Fifty-five (27.5%) of the 200 patients treated with self-expanding endografts had aortic neck dilatation compared to only 3 (7.1%) of the 42 patients treated with balloon-expandable endografts (p = 0.023). Forty-nine (24.5%) patients in the self-expanding group versus only 3 (7.1%) patients of the balloon-expandable group presented with endograft migration (p = 0.034); all had dilated necks. The difference between the means of neck dilatation for the Lifepath balloon-expandable stent-graft and the Excluder self-expanding endoprosthesis was statistically significant (p = 0.011, 95% CI 0.07 to 0.91).


CONCLUSIONS
Aortic neck dilatation following endovascular AAA repair appears to be correlated with self-expanding endografts, which may contribute to a higher incidence of graft migration compared to that occurring with balloon-expandable endografts.
Dalainas
Ilias
I
1st Unit of Vascular Surgery, Policlinico San Donato, School of Vascular Surgery, University of Milan, Italy. hdlns@freemail.gr
Nano
Giovanni
G
Bianchi
Paolo
P
Ramponi
Fabio
F
Casana
Renato
R
Malacrida
Giovanni
G
Tealdi
Domenico G
DG
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome