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Proximal Landing Zone Growth after Thoracic Endovascular Aortic Repair
Tugce Öz1, Nikolaos Tsilimparis1, Carlota Fernandez Prendes1
1Department of Vascular Surgery, University Hospital, LMU Munich, Munich, Germany.
Summary
Proximal landing zone (PLZ) growth after thoracic endovascular aortic repair (TEVAR) is faster than in the native aorta. This PLZ expansion increases risks of type Ia endoleaks and device migration, necessitating close patient monitoring.
Area of Science:
- Vascular Surgery
- Endovascular Aortic Repair
- Aortic Anatomy
Background:
- The proximal landing zone (PLZ) is critical for thoracic endovascular aortic repair (TEVAR) success.
- Understanding PLZ diameter changes and associated risks is essential for patient management.
Purpose of the Study:
- To quantitatively assess PLZ growth after TEVAR.
- To identify predictors of PLZ diameter progression.
- To evaluate the impact of PLZ growth on adverse events.
Main Methods:
- Retrospective cohort study of 76 patients undergoing TEVAR with PLZ.
- Longitudinal mixed-effects models used to analyze PLZ diameter changes.
- Univariate/multivariate and Cox regression analyses identified risk factors and event associations.
Main Results:
- Average PLZ growth was 1.7 mm/year, significantly exceeding native aorta growth (0.7 mm/year).
- Predictors of growth included time, pre-operative PLZ diameter, oversizing, and patient age.
- PLZ growth correlated with increased risk of type Ia endoleaks and device migration (≥10 mm).
Conclusions:
- PLZ exhibits accelerated growth post-TEVAR compared to the native aorta.
- Anatomical and procedural factors influence PLZ progression.
- Significant PLZ growth is linked to higher rates of endoleaks and migration, underscoring the need for vigilant follow-up and tailored procedural planning.
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