Changing aneurysmal morphology after endovascular grafting: relation to leakage or persistent perfusion

J Endovasc Surg. 1997 Feb;4(1):23-30. doi: 10.1583/1074-6218(1997)004<0023:CAMAEG>2.0.CO;2.

Abstract

Purpose: To relate changing abdominal aortic aneurysm (AAA) morphology after endovascular grafting to the presence of leakage, collateral perfusion, and other factors.

Methods: Thirty-five patients who underwent successful AAA endovascular grafting were evaluated. Self-expanding Z-stents and Dacron grafts were applied in bifurcated and aortomonoiliac systems. Postoperative diameter changes were calculated from repeated spiral computed tomographic scans, angiograms, and ultrasonic phase-locked echo-tracking scans during a median 6-month follow-up (interquartile range [IQR] 3 to 12).

Results: At 12 months, the diameters of completely excluded aneurysms had decreased 6 mm (IQR 2 to 11; p = 0.006). The proximal graft-anchoring stents had dilated 2 mm (IQR 0.5 to 3.3; p = 0.01). The aortic diameters immediately below the renal arteries but above the stents had not changed. Endoleakage and collateral perfusion (n = 13) were each associated with preserved aneurysm size and a 12 times higher risk of aneurysm dilation. After the leakage or the collateral perfusion had been treated, the aneurysm size decreased. Aneurysms with extensive intraluminal thrombi presented a reduced risk of leakage or perfusion.

Conclusions: The diameters of endovascularly excluded AAAs decrease, except in cases of leakage or perfusion. Careful follow-up of patients with aortic endografts is necessary.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty / methods*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography
  • Blood Vessel Prosthesis*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Polyethylene Terephthalates
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Prosthesis Failure
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Stents*
  • Tomography, X-Ray Computed
  • Ultrasonography

Substances

  • Polyethylene Terephthalates