Endograft migration after thoracic endovascular aortic repair

Area of Science:

• Vascular Surgery
• Medical Imaging
• Biomedical Engineering

Background:

• Thoracic endovascular aortic repair (TEVAR) is a minimally invasive treatment for various thoracic aortic pathologies.
• Late endograft migration is a potential complication that can impact long-term outcomes.
• Understanding the incidence and risk factors of migration is crucial for improving patient care.

Purpose of the Study:

• To determine the incidence and timing of late endograft migration following TEVAR.
• To identify potential risk factors associated with endograft migration.
• To evaluate the clinical significance of migration and its impact on treatment outcomes.

Main Methods:

• Retrospective analysis of 123 patients who underwent TEVAR between 2005 and 2015.
• Minimum 6-month imaging follow-up with analysis by three independent readers.
• Migration defined as >10 mm stent graft shift or symptomatic displacement; standardized measurement protocols were used.

Main Results:

• Migration occurred in 7.3% of patients, often in the overlapping or distal landing zones.
• Aortic elongation and thoracic aortic aneurysms (TAA) were significant predisposing factors (P=.003 and P=.01).
• Freedom from migration was 99.1% at 1 year, decreasing to 86.1% by 5 years.

Conclusions:

• Endograft migration is a relevant complication after TEVAR, particularly in patients with TAA and aortic elongation.
• Specific evaluation of follow-up imaging is recommended to detect migration early.
• Proactive monitoring can help identify migration before it leads to complications like endoleaks.