Publication: Delayed Graft Dislocation After Thoracic Aortic Endovascular Repair
Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Endograft dislocation in thoracic aorta has not been widely studied.
Objectives
The purpose of this study is to analyze the incidence and predisposing factor in a
single centre experience after 117 procedures.
Method
Between November 2000 and December 2011, all consecutive patients undergoing
endovascular repair for descending thoracic or thoraco-abdominal aortic disease
were identified. Follow-up imaging protocol included triple-phase CT-angiography
at 1, 4, and 12 months, and annually thereafter. Migration was defined as proximal/
distal movements >10 mm relative to anatomical landmarks or any movement
leading to symptoms or reintervention.
Result
We identified 117 patients. Mean follow-up was 32 months (range, 1-144). Overall,
five (4.3%) patients with thoracic EG dislocation were identified. Dislocation was
classified as collapse/infolding in 3 cases and migration in 2. Mean delay of the
dislocation was 12.7 months. Only one patient developed symptoms and required
an additional endograft. In the group of dislocated endografts, mean age (53 ± 20
vs. 68 ± 15, P = .032) and the diameter of the aortic lesion were lower (4.1cm ± 1.6
vs. 5.6cm ± 1.8, P = .069), and the proximal landing zone at “zones 2 and 3” were
more frequently used (5 vs. 65, P = 0.81). All but one patient with collapse/infolding
are still alive and doing well at a mean follow-up of 80 months.
Conclusion
Dislocation is an infrequent complication, but not so rare. Young age, small aortic
diameter , and proximal sealing at the distal arch were the most important data
associated with this complication.
KEY WORDS
Endograft dislocation, endograft migration
Description
Piffaretti G,1 Negri S,1 Ferraro S,1 Bossi M,1 Rivolta N,1 Fontana F,2 Castelli P1
1Vascular Surgery, Department of Surgery and
Morphological Sciences,
2Interventional Radiology, Department of Radiology
Circolo University Hospital, University of Insubria
School of Medicine, Varese, Italy