title: Disintegration of the Top Stent on Zenith Abdominal Aortic Stent-Grafts.
abstract: OBJECTIVE
  To describe a heretofore unreported complication involving the Zenith Low Profile (LP) stent-graft.
  
  
  METHODS
  Two men, aged 75 and 67 years, respectively, underwent abdominal aortic aneurysm repair with a Zenith LP device. At 4 and 3 years, respectively, computed tomography angiography revealed separation of the proximal fixation stent from the stent-graft. In the first patient, there was stent-graft migration but no evidence of an endoleak; however, the aneurysm had grown. A fenestrated cuff was placed, sealing distally in the previous LP graft. The second patient had a type I endoleak. Open surgery was performed, and the main body of the graft was explanted. Postoperative examination of the device revealed that the fixation sutures on the suprarenal stent were still attached to the stent and had eroded through the graft material.
  
  
  CONCLUSIONS
  Physicians should be aware of the potential for top stent separation from the Zenith LP stent-graft as a cause of endoleak and migration.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden david.lindstrom@ki.se.
authors.forename: David
authors.initials: D
authors.lastname: Lindström
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Carl Magnus
authors.initials: CM
authors.lastname: Wahlgren
authors.affiliation: Vascular Center, Skåne University Hospital, Malmö, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Sonesson
authors.affiliation: Vascular Center, Skåne University Hospital, Malmö, Sweden.
authors.forename: Timothy
authors.initials: T
authors.lastname: Resch
mesh_terms: 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*; D000072226:Computed Tomography Angiography; D020878:Device Removal; D057867:Endoleak / Q000209:etiology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome
keywords: abdominal aortic aneurysm; aneurysm growth; complication; device failure; endograft; endoleak; endovascular aneurysm repair; explantation; fenestrated cuff; migration; proximal fixation stent; stent-graft