title: Systematic review and meta-analysis of migration after endovascular abdominal aortic aneurysm repair.
abstract: OBJECTIVE
  To identify patients who are under higher threat for migration because of an old generation stent graft application.
  
  
  METHODS
  A systematic review and meta-analysis of the literature was undertaken to identify all studies which included older generation endografts and data reporting on graft migration after EVAR. Outcome data were pooled and combined, and were calculated using fixed or random effects models.
  
  
  RESULTS
  From 2000 to 2014, 22 retrospective studies were identified reporting on stent- graft migration after EVAR (8.6%). From those patients, 39% received re-intervention with the mean time of identification ranging from 12 to 36 months. Six of these retrospective nonrandomized studies were eligible for meta-analysis. AAA diameter (AAA diameter: 0.719 mm; 95% confidence interval [CI]: 0.00065-1.4384 mm; p = 0.00497) and neck length (neck length: 4.36 mm; 95% CI: 1.3277-7.394; p = 0.0048) were the only significant factors associated with stent- graft migration. Neck diameter and neck angulation did not have any important influence on stent-graft migration.
  
  
  CONCLUSIONS
  Patients with large AAA and short necks who were treated with older generation stent grafts such as AneurX and Talent are in higher risk for endograft migration than others. Stent- graft migration consists of an insidious and underestimated threat.
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece spanos.kon@gmail.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spanos
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Karathanos
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Saleptsis
authors.affiliation: Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Giannoukas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Migration; aneurysm neck characteristics; endovascular aortic aneurysm repair