Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study
Background Migration of the stent-graft post-thoracic endovascular aortic repair (TEVAR) is not uncommon; however, it is sparsely reported. The objective of this study was to assess the incidence, risk factors, and complications of stent-graft migration post-TEVAR. Materials and Methods T...
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| Format: | Article |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-09-01
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| Series: | Indian Journal of Radiology and Imaging |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754317 |
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| author | Amit Ajit Deshpande Niraj Nirmal Pandey Manish Shaw Sanjeev Kumar Priya Jagia Sanjiv Sharma Shiv Choudhary |
| author_facet | Amit Ajit Deshpande Niraj Nirmal Pandey Manish Shaw Sanjeev Kumar Priya Jagia Sanjiv Sharma Shiv Choudhary |
| author_sort | Amit Ajit Deshpande |
| collection | DOAJ |
| description | Background Migration of the stent-graft post-thoracic endovascular aortic repair (TEVAR) is not uncommon; however, it is sparsely reported. The objective of this study was to assess the incidence, risk factors, and complications of stent-graft migration post-TEVAR.
Materials and Methods Thirty-one patients who underwent TEVAR were retrospectively analyzed. The demographic, anatomical, and procedure-related factors were assessed. The measurements were done along the greater curvature of aorta around two fixed anatomic landmarks, that is, left common carotid artery or neoinnominate artery (hybrid repair) proximally and celiac artery distally. Aortic elongation and migration at proximal, distal, as well as at overlapping zone were measured. More than 10 mm of migration was considered significant.
Results Significant migration was observed in six (19%) patients. No significant migration was observed in the overlapping zone. The proximal landing zone 3 (odds ratio [OR] 12.78, p 0.01) was a significant risk factor, whereas landing zone 2 was a protective factor against the migration (OR 0.08, p 0.02). The odds for migration were more in segments I/3 and II/3 compared with I/2 and II/2, respectively, as per Modified Arch Landing Areas Nomenclature. A single complication was seen in the migration group which was treated by an overlapping stent graft.
Conclusion The stent-graft migration after TEVAR is not uncommon. Type 3 proximal landing zone was a significant risk factor for migration with an increased risk toward I/3 and II/3. Proximal landing zone 2 as well as adequate overlapping distance in multiple stent grafts can prevent migration.
Ethical Approval No IECPG-227/24.06.2020 |
| first_indexed | 2024-12-10T06:07:36Z |
| format | Article |
| id | doaj.art-739f8f838f964562905f861163778a31 |
| institution | Directory Open Access Journal |
| issn | 0971-3026 1998-3808 |
| language | English |
| last_indexed | 2024-12-10T06:07:36Z |
| publishDate | 2022-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Radiology and Imaging |
| spelling | doaj.art-739f8f838f964562905f861163778a312022-12-22T01:59:39ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Radiology and Imaging0971-30261998-38082022-09-01320332433110.1055/s-0042-1754317Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort StudyAmit Ajit Deshpande0Niraj Nirmal Pandey1Manish Shaw2Sanjeev Kumar3Priya Jagia4Sanjiv Sharma5Shiv Choudhary6Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, IndiaBackground Migration of the stent-graft post-thoracic endovascular aortic repair (TEVAR) is not uncommon; however, it is sparsely reported. The objective of this study was to assess the incidence, risk factors, and complications of stent-graft migration post-TEVAR. Materials and Methods Thirty-one patients who underwent TEVAR were retrospectively analyzed. The demographic, anatomical, and procedure-related factors were assessed. The measurements were done along the greater curvature of aorta around two fixed anatomic landmarks, that is, left common carotid artery or neoinnominate artery (hybrid repair) proximally and celiac artery distally. Aortic elongation and migration at proximal, distal, as well as at overlapping zone were measured. More than 10 mm of migration was considered significant. Results Significant migration was observed in six (19%) patients. No significant migration was observed in the overlapping zone. The proximal landing zone 3 (odds ratio [OR] 12.78, p 0.01) was a significant risk factor, whereas landing zone 2 was a protective factor against the migration (OR 0.08, p 0.02). The odds for migration were more in segments I/3 and II/3 compared with I/2 and II/2, respectively, as per Modified Arch Landing Areas Nomenclature. A single complication was seen in the migration group which was treated by an overlapping stent graft. Conclusion The stent-graft migration after TEVAR is not uncommon. Type 3 proximal landing zone was a significant risk factor for migration with an increased risk toward I/3 and II/3. Proximal landing zone 2 as well as adequate overlapping distance in multiple stent grafts can prevent migration. Ethical Approval No IECPG-227/24.06.2020http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754317tevarstent migrationaortic dissectionaortic aneurysmmalan |
| spellingShingle | Amit Ajit Deshpande Niraj Nirmal Pandey Manish Shaw Sanjeev Kumar Priya Jagia Sanjiv Sharma Shiv Choudhary Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study Indian Journal of Radiology and Imaging tevar stent migration aortic dissection aortic aneurysm malan |
| title | Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study |
| title_full | Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study |
| title_fullStr | Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study |
| title_full_unstemmed | Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study |
| title_short | Stent-Graft Migration Post-Endovascular Repair of Thoracic Aorta: A Retrospective Cohort Study |
| title_sort | stent graft migration post endovascular repair of thoracic aorta a retrospective cohort study |
| topic | tevar stent migration aortic dissection aortic aneurysm malan |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754317 |
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