Long-Term Influence of Suprarenal or Infrarenal Fixation on Proximal Neck Dilatation and Stentgraft Migration After EVAR

Stent graft Surface Movement after Infrarenal Abdominal Aortic Aneurysm Repair: Comparison of Patients with and without a Type 2 Endoleak

“…Overall, at mid-term follow up, the observed stent graft related endoleak rate of 4.2% is in accordance with reported incidences of 2.1e13.8%. 4,26,36 Limitations Admittedly, this study is limited by its retrospective nature. Comparing the post-procedural and the final MSCT follow up resulted in a heterogeneous time interval for measurements, ranging from 6 months up to 10 years, but without a significant difference between compared groups.…”

“…As reported by different authors, significant dilation of the neck diameter can lead to complete loss of the anchoring zone and to migration. 2,22,25 The results lead to the suspicion that dilation of the proximal neck depends not only on anatomical factors and the natural evolution of the aneurysmal disease, as stated by Pintoux et al, 26 but is also related to stent graft movement. Based on the available evidence, 27e32 type 2 endoleaks are not prone to lead to major adverse events, especially to rupture.…”

Suprarenal stent perforation after endovascular abdominal aortic aneurysm repair

“…The superior stents are noncovered, containing caudally oriented barbs intended to extend proximal to the renal arteries to prevent migration in the absence of suprarenal dilatation. 13 Use of stent grafts with suprarenal stents over devices that use radial forces for fixation has been recommended for patients with angulated aortic necks, although superiority of one device over another in long-term durability and outcomes has not been demonstrated. 14 Success rates using the Cook device are excellent, and long-term follow-up has shown admirable patency with minimal complications.…”

Proximal Aortic Neck Progression: Before and After Abdominal Aortic Aneurysm Treatment

“…In the long term, the absence of proximal stent-graft fixation system enhances proximal migration. Conversely, the inter-renal or infrarenal proximal neck dilatation does not depend on the type of proximal fixation but on anatomic factors and on the natural evolution of the aneurysmal disease (31). In the comparative study by Pintoux et al, freedom from dilatation did not differ between infrarenal and suprarenal fixation although proximal graft migration was more frequent with infrarenal fixation (31).…”