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AneuRx device migration: incidence, risk factors, and consequences
Sergio M Sampaio1, Jean M Panneton, Geza Mozes
1Division of Vascular Surgery, Mayo Clinic, Rochester, MN, USA.
Annals of Vascular Surgery
|March 23, 2005
Summary
Device migration after endovascular abdominal aortic aneurysm repair (EVAR) with the AneuRx endograft occurs in 15.6% of patients. Longer proximal necks and greater device overlap reduce migration risk, which is linked to type I endoleaks.
Area of Science:
- Vascular Surgery
- Medical Devices
- Aortic Aneurysm Treatment
Background:
- Endovascular abdominal aortic aneurysm repair (EVAR) success depends on device stability.
- Device migration is a concern, with risk factors debated.
- The AneuRx endograft's migration characteristics require definition.
Purpose of the Study:
- To determine the incidence, risk factors, and clinical implications of device migration after AneuRx EVAR.
- To identify anatomical predictors of AneuRx endograft migration.
- To assess the association between migration and type I endoleaks.
Main Methods:
- Retrospective review of 109 patients undergoing primary AneuRx EVAR.
- Analysis of preoperative CT scans for anatomical factors (neck length, diameter, angulation, calcification, thrombus).
- Postoperative CT scans measured device migration (>5 mm increase from renal artery). Kaplan-Meier and Cox proportional hazards models used.
Main Results:
- Migration occurred in 9 patients, with a 30-month estimated incidence of 15.6%.
- Migration was significantly associated with proximal type I endoleaks (HR=3.39, p=0.007).
- Longer proximal necks (OR=0.71) and greater device overlap (OR=0.56) were protective against migration.
Conclusions:
- Device migration is a notable event after AneuRx implantation, linked to type I endoleaks.
- Optimizing proximal neck anatomy and device overlap can mitigate migration risk.
- Migration appears independent of device oversizing but may correlate with late neck dilation.