Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: A cautionary note

Conners, M. S., Sternbergh, W. C., Carter, G., Tonnessen, B. H., Yoselevitz, M. and Money, S. R. (2002). Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: A cautionary note. In: 26th Annual Meeting of the Southern-Association-for-Vascular-Surgery, Miami Beach, FL, United States, (476-482). 16-19 January 2002. doi:10.1067/mva.2002.126561

Author Conners, M. S.
Sternbergh, W. C.
Carter, G.
Tonnessen, B. H.
Yoselevitz, M.
Money, S. R.
Title of paper Endograft migration one to four years after endovascular abdominal aortic aneurysm repair with the AneuRx device: A cautionary note
Conference name 26th Annual Meeting of the Southern-Association-for-Vascular-Surgery
Conference location Miami Beach, FL, United States
Conference dates 16-19 January 2002
Journal name Journal of Vascular Surgery   Check publisher's open access policy
Place of Publication Philadelphia, PA, United States
Publisher Mosby
Publication Year 2002
Sub-type Fully published paper
DOI 10.1067/mva.2002.126561
ISSN 0741-5214
Volume 36
Issue 3
Start page 476
End page 482
Total pages 6
Language eng
Formatted Abstract/Summary
Background: Positional stability of the endograft is essential for long-term durability after endovascular abdominal aortic aneurysm repair (EAR). However, the cumulative risk of delayed endograft migration has been sparsely reported.

Method: A total of 91 patients studied underwent EAR with the AneuRx endograft with a minimum 1 year from implantation. Data from a prospective database were assessed for proximal endograft migration, defined as ≥5 mm change from the initial endograft position. Multiple anatomic characteristics were also examined. Sixty-nine patients were alive, with complete follow-up at 1 year, with a mean time from implantation of 33.2 ± 1.1 months. Data are mean ± SEM.

Results: Endograft migration occurred in 15 patients, giving a cumulative event rate of 7.2% (5/69) at 1 year, 20.4% (10/49) at 2 years, 42.1% (8/19) at 3 years, and 66.7% (2/3) at 4 years post-EAR (P = .01). Although the initial aortic neck diameter did not differ between the groups (21.5 ± 0.6 mm vs 21.8 ± 0.3 mm, P = .61), significant (P <.05), late aortic neck enlargement was seen in patients with migration (25.0 ± 1.6 mm, 26.2 ± 1.2 mm, and 27.0 ± 1.0 mm at 1,2, and 3 years, respectively) but not in nonmigrators. Regression analysis demonstrated a statistically significant (P < .05) correlation between endograft oversizing and late aortic neck dilation. Overall migration risk was 29.2% in patients oversized >20% and 18.6% in patients oversized ≤20%. Aortic neck angulation (23.4 ± 6.6 degrees vs 23.5 ± 3.3 degrees, P = .99), aortic neck length (25.9 ± 2.5 mm vs 27.0 ± 1.6 mm, P = .74), initial endograft/aortic neck overlap (18.6 ± 2.6 mm vs 19.4 ± 1.4 mm, P = .80) and size of abdominal aortic aneurysm (55.5 ± 1.5 mm vs 54.9 ± 1.4 mm, P = .84) were similar between migrators and nonmigrators, respectively. Secondary endovascular treatment with aortic cuffs was required in five patients with device migration.

Conclusions: Device migration after EAR with the AneuRx endograft occurred with significant frequency, the incidence of which increased with the length of follow-up. Late aortic neck dilation was significantly associated with migration. Oversizing of the endograft of >20% may accelerate this late aortic neck dilation. However, the etiologies of endograft migration were likely multifactorial, as the majority (8/15) of patients experiencing migration were oversized <20%. Although endovascular repair of these migrations is usually possible, the long-term durability of these secondary procedures is unknown. Careful surveillance for this endograft failure mode must be an essential component of post-EAR follow-up.
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:00:32 EST