title: Size of the proximal neck in AAAs treated with balloon-expandable stent-grafts: CTA findings in mid- to long-term follow-up.
abstract: OBJECTIVE
  To determine the evolution of the proximal aortic neck diameter in mid- to long-term follow-up after endovascular aneurysm repair of abdominal aortic aneurysm (AAA) with a balloon-expandable stent-graft.
  
  
  METHODS
  Thirty patients (27 men; average age 71 years, range 56-87) with infrarenal AAAs were treated with the SETA-Latecba balloon-expandable stent-graft (6 aortomonoiliac and 24 bifurcated configurations). Follow-up ranged from 4 to 8 years (mean 73.4 months). Computed tomography was done systematically before the procedure, after implantation (1-3 months), at 1 year, and annually thereafter. The last follow-up scan was utilized to measure the proximal neck for purposes of comparison with baseline and the initial post-implant scans.
  
  
  RESULTS
  Five patients died during follow-up of causes unrelated to the procedure. No endoleaks or graft migrations were observed. The pre-deployment proximal neck diameter (a) averaged 23.4 mm (range 18-32), the diameter after deployment of the stent-graft (b) averaged 24.9 mm (range 18-34), and the most recent follow-up proximal neck measurement (c) averaged 23.8 mm (range 18-31). Comparing the last follow-up to the post-implant measurements (c-b), the neck diameter decreased in 15 (50%) patients [7 with short necks (i.e., <15 mm)] and remained unchanged (no variation) in 15 (50%) patients (4 with short necks). All patients treated with the SETA-Latecba balloon-expandable stent-graft showed stability of the proximal aortic neck diameter in mid- to long-term follow-up.
  
  
  CONCLUSIONS
  The study showed that the diameter reached at initial deployment did not increase further in the long term, which supports the safety and reliability of this modular balloon-expandable stent-graft and illustrates that this device does not produce dilatation of the proximal neck after deployment. Future dilatation of the aortic neck is unlikely, and consequently, migration or delayed type I endoleak are also unlikely.
authors.affiliation: Cirugía Vascular, Hospital Ramos Mejía, Buenos Aires, Argentina.
authors.forename: Miguel A M
authors.initials: MA
authors.lastname: Peirano
authors.forename: Hernán G
authors.initials: HG
authors.lastname: Bertoni
authors.forename: Darío S
authors.initials: DS
authors.lastname: Chikiar
authors.forename: Jorge M P
authors.initials: JM
authors.lastname: Martínez
authors.forename: Germán A
authors.initials: GA
authors.lastname: Girella
authors.forename: Héctor D
authors.initials: HD
authors.lastname: Barone
authors.forename: Randolph
authors.initials: R
authors.lastname: Guzman
authors.forename: Yvan
authors.initials: Y
authors.lastname: Douville
authors.forename: Tieying
authors.initials: T
authors.lastname: Yin
authors.forename: Mark
authors.initials: M
authors.lastname: Nutley
authors.forename: Ze
authors.initials: Z
authors.lastname: Zhang
authors.forename: Robert
authors.initials: R
authors.lastname: Guidoin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002404:Catheterization; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome