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Delayed graft dislocation after thoracic aortic endovascular repair.
G Piffaretti1, S Negri1, S Ferraro1
1Vascular Surgery, Department of Surgery and Morphological Sciences, Circolo University Hospital, University of Insubria School of Medicine, Varese, Italy.
Kathmandu University Medical Journal (KUMJ)
|January 2, 2015
Summary
Thoracic endograft dislocation is an infrequent but significant complication. Predisposing factors include younger age, smaller aortic diameter, and proximal landing zones in thoracic endovascular repair.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Imaging
Background:
- Endograft dislocation in the thoracic aorta is an understudied complication.
- Understanding its incidence and risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze the incidence and predisposing factors of thoracic endograft dislocation.
- To report findings from a single-center experience of 117 endovascular repair procedures.
Main Methods:
- Retrospective review of 117 consecutive patients undergoing thoracic endovascular repair (TEVAR).
- Follow-up imaging included CT-angiography at specified intervals.
- Migration defined as >10 mm movement or symptomatic displacement requiring reintervention.
Main Results:
- Five patients (4.3%) experienced thoracic endograft dislocation (3 collapse/infolding, 2 migration).
- Dislocations occurred at a mean of 12.7 months post-procedure.
- Younger age (53 vs. 68 years) and smaller aortic diameter (4.1 vs. 5.6 cm) were associated with dislocation.
Conclusions:
- Thoracic endograft dislocation is an infrequent but notable complication.
- Younger patient age, smaller aortic diameter, and proximal landing zones (distal arch) are key associated factors.
- Most dislocations were managed conservatively with good long-term outcomes.
