Changes in aneurysm morphology and stent-graft configuration after endovascular repair of aneurysms of the descending thoracic aorta
Resch, Timothy ; Koul, Bansi LU ; Dias, Nuno LU
; Lindblad, Bengt
LU
and Ivancev, Krassi
LU
(2001)
In Journal of Thoracic and Cardiovascular Surgery
122(1).
p.47-52
- Abstract
- OBJECTIVE: We sought to study changes in morphology and stent-graft configuration of descending thoracic aortic aneurysms after endovascular repair. METHODS: Twenty-three patients treated with custom-made stent-grafts were studied. The stent-graft consisted of continuous, stainless-steel Z stents mounted within a polyester graft. In the last 11 cases the stents were interconnected with 3 longitudinal wires. Contrast-enhanced spiral computed tomography was performed preoperatively and at 1, 3, and every 6 months postoperatively. Angiography was used preoperatively and at 1-year follow-up. Proximal and distal necks were assessed for diameter and length. Aneurysm diameter, endoleaks, stent-graft migration, and changes in stent-graft... (More)
- OBJECTIVE: We sought to study changes in morphology and stent-graft configuration of descending thoracic aortic aneurysms after endovascular repair. METHODS: Twenty-three patients treated with custom-made stent-grafts were studied. The stent-graft consisted of continuous, stainless-steel Z stents mounted within a polyester graft. In the last 11 cases the stents were interconnected with 3 longitudinal wires. Contrast-enhanced spiral computed tomography was performed preoperatively and at 1, 3, and every 6 months postoperatively. Angiography was used preoperatively and at 1-year follow-up. Proximal and distal necks were assessed for diameter and length. Aneurysm diameter, endoleaks, stent-graft migration, and changes in stent-graft configuration were evaluated. RESULTS: During follow-up (median, 18 months; range, 1-48 months), excluded aneurysms decreased in diameter by 4 mm (0.5-10 mm, P =.0018). Endoleaks prevented size decrease. Five patients displayed neck dilatation, 4 at both the proximal and distal fixation sites and 1 only distally. In 7 (30%) patients there was proximal migration of the distal end of the stent-graft. Three (13%) patients displayed both distal migration of the proximal end of the stent-graft and proximal migration of the distal end of the stent-graft. There was a significant correlation between stent-graft kinking and appearance of proximal or distal stent-graft migration (P =.05 and P =.0007, respectively). In no case did the migration lead to appearance of an endoleak before intervention was performed. CONCLUSION: Excluded descending thoracic aortic aneurysms decrease in size on midterm follow-up. A subgroup of patients prone to neck dilatation might exist. A combination of neck dilatation and vector forces acting on stent-grafts in the tortuous thoracic aorta might lead to stent-graft migration. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1122575
- author
- Resch, Timothy
; Koul, Bansi
LU
; Dias, Nuno
LU
; Lindblad, Bengt
LU
and Ivancev, Krassi
LU
- organization
- publishing date
- 2001
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Thoracic and Cardiovascular Surgery
- volume
- 122
- issue
- 1
- pages
- 47 - 52
- publisher
- Mosby-Elsevier
- external identifiers
-
- pmid:11436036
- scopus:0035412861
- pmid:11436036
- ISSN
- 1097-685X
- DOI
- 10.1067/mtc.2001.113025
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Unit for Clinical Vascular Disease Research (013242410), Emergency medicine/Medicine/Surgery (013240200), Medical Radiology Unit (013241410), Thoracic Surgery (013230027)
- id
- 94c96c02-b7bc-4e21-b816-d235157d63b4 (old id 1122575)
- date added to LUP
- 2016-04-01 16:39:53
- date last changed
- 2022-01-28 21:17:38
@article{94c96c02-b7bc-4e21-b816-d235157d63b4,
abstract = {{OBJECTIVE: We sought to study changes in morphology and stent-graft configuration of descending thoracic aortic aneurysms after endovascular repair. METHODS: Twenty-three patients treated with custom-made stent-grafts were studied. The stent-graft consisted of continuous, stainless-steel Z stents mounted within a polyester graft. In the last 11 cases the stents were interconnected with 3 longitudinal wires. Contrast-enhanced spiral computed tomography was performed preoperatively and at 1, 3, and every 6 months postoperatively. Angiography was used preoperatively and at 1-year follow-up. Proximal and distal necks were assessed for diameter and length. Aneurysm diameter, endoleaks, stent-graft migration, and changes in stent-graft configuration were evaluated. RESULTS: During follow-up (median, 18 months; range, 1-48 months), excluded aneurysms decreased in diameter by 4 mm (0.5-10 mm, P =.0018). Endoleaks prevented size decrease. Five patients displayed neck dilatation, 4 at both the proximal and distal fixation sites and 1 only distally. In 7 (30%) patients there was proximal migration of the distal end of the stent-graft. Three (13%) patients displayed both distal migration of the proximal end of the stent-graft and proximal migration of the distal end of the stent-graft. There was a significant correlation between stent-graft kinking and appearance of proximal or distal stent-graft migration (P =.05 and P =.0007, respectively). In no case did the migration lead to appearance of an endoleak before intervention was performed. CONCLUSION: Excluded descending thoracic aortic aneurysms decrease in size on midterm follow-up. A subgroup of patients prone to neck dilatation might exist. A combination of neck dilatation and vector forces acting on stent-grafts in the tortuous thoracic aorta might lead to stent-graft migration.}},
author = {{Resch, Timothy and Koul, Bansi and Dias, Nuno and Lindblad, Bengt and Ivancev, Krassi}},
issn = {{1097-685X}},
language = {{eng}},
number = {{1}},
pages = {{47--52}},
publisher = {{Mosby-Elsevier}},
series = {{Journal of Thoracic and Cardiovascular Surgery}},
title = {{Changes in aneurysm morphology and stent-graft configuration after endovascular repair of aneurysms of the descending thoracic aorta}},
url = {{http://dx.doi.org/10.1067/mtc.2001.113025}},
doi = {{10.1067/mtc.2001.113025}},
volume = {{122}},
year = {{2001}},
}