Journal of Vascular Surgery
Volume 52, Issue 2 , Pages 303-307, August 2010

Long-term follow-up of neck expansion after endovascular aortic aneurysm repair

Presented at the Twenty-fourth Western Vascular Society Annual Meeting, September 19-22, 2009, Tuscon, Ariz.

Division of Vascular Surgery, University of California, San Francisco, Calif

Received 13 October 2009; accepted 9 March 2010.

Objective

This study determined the rate, extent, and clinical significance of neck dilatation after endovascular aneurysm repair (EVAR).

Methods

The study included 46 patients who underwent elective EVAR using bifurcated Zenith stent grafts (Cook, Bloomington, Ind) and had at least 48 months of clinical and radiographic follow-up. Computed tomography images were analyzed on a 3-dimensional workstation (TeraRecon, San Mateo, Calif). Neck diameter was measured 10 mm below the most inferior renal artery in planes orthogonal to the aorta. Nominal stent graft diameter was obtained from implantation records.

Results

Median follow-up was 59 months (range, 48-120 months). Neck dilation occurred in all 46 patients. The rate of neck dilation was greatest at early follow-up intervals. At 48 months, median neck dilation was 5.3 mm (range, 2.3-9.8 mm). The extent of neck dilation at 48 months correlated with percentage of stent graft oversizing (Spearman ρ = 0.61, P < .001). No type I endoleak or migration >5 mm occurred.

Conclusions

After EVAR with the Zenith stent graft, the neck dilates until its diameter approximates the diameter of the stent graft. Neck dilation was not associated with type I endoleak or migration of the stent graft.

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 This publication was supported by NIH/NCRR/OD UCSF-CTSI Grant Number KL2 RR024130. Its contents are the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

 Competition of interest: Dr Chuter receives research support, travel expenses, and royalties from licensed patents from Cook Medical, the manufacturers of the Zenith stent graft.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(10)00757-3

doi:10.1016/j.jvs.2010.03.018

Journal of Vascular Surgery
Volume 52, Issue 2 , Pages 303-307, August 2010

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