Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair

R.C.L. Schuurmann (Corresponding Author), Kim van Noort, S.P. Overeem, Ruben van Veen, Kenneth Ouriel, William Jordan, Bart Muhs, Yannick 't Mannetje, Michel Reijnen, Bram Fioole, Cagdas Unlu, Peter Brummel, J.P.P.M. de Vries

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)

Abstract

Purpose: To describe the added value of determining changes in position and apposition on computed tomography angiography (CTA) after endovascular aneurysm repair (EVAR) to detect early caudal displacement of the device and to prevent type Ia endoleak. Methods: Four groups of elective EVAR patients were selected from a dataset purposely enriched with type Ia endoleak and migration (>10 mm) cases. The groups included cases of late type Ia endoleak (n=36), migration (n=9), a type II endoleak (n=16), and controls without post-EVAR complications (n=37). Apposition of the endograft fabric with the aortic neck, shortest distance between the fabric and the renal arteries, expansion of the main body (or dilatation of the aorta in the infrarenal sealing zone), and tilt of the endograft toward the aortic axis were determined on the first postoperative and the last available CTA scan without type Ia endoleak or migration. Differences in these endograft dimensions were compared between the first vs last scan and among the 4 groups. Results: No significant differences in endograft configurations were observed among the groups on the first postoperative CTA scan. On the last CTA scan before a complication arose, the position of the fabric relative to the renal arteries, expansion of the main body, and apposition of the fabric with the aortic neck were significantly different between the type Ia endoleak (median follow-up 15 months) and migration groups (median follow-up 23 months) compared with the control group (median follow-up 19 months). Most endograft dimensions had changed significantly compared with the first postoperative CTA scan for all groups. Apposition had increased in the control group but had decreased significantly in the type Ia endoleak and migration groups. Conclusion: Progressive changes in dimensions of the endograft within the infrarenal neck could be detected on regular CTA scans before the complication became urgent in many patients.
Original languageEnglish
Pages (from-to)366-375
Number of pages10
JournalJournal of Endovascular Therapy
Volume25
Issue number3
DOIs
Publication statusPublished - 1 Jun 2018

Fingerprint

Endoleak
Aneurysm
Renal Artery
Control Groups
Aorta
Computed Tomography Angiography
Dilatation
Equipment and Supplies

Keywords

  • UT-Hybrid-D
  • aneurysm neck
  • type I endoleak
  • 3D imaging
  • stent-graft
  • endovascular aneurysm repair
  • migration
  • 3D reconstructions
  • endograft
  • geometry
  • abdominal aortic aneurysm

Cite this

Schuurmann, R.C.L. ; van Noort, Kim ; Overeem, S.P. ; van Veen, Ruben ; Ouriel, Kenneth ; Jordan, William ; Muhs, Bart ; 't Mannetje, Yannick ; Reijnen, Michel ; Fioole, Bram ; Unlu, Cagdas ; Brummel, Peter ; de Vries, J.P.P.M. / Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair. In: Journal of Endovascular Therapy. 2018 ; Vol. 25, No. 3. pp. 366-375.
@article{3189ef12dab649cbb1a9e7d396a5d590,
title = "Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair",
abstract = "Purpose: To describe the added value of determining changes in position and apposition on computed tomography angiography (CTA) after endovascular aneurysm repair (EVAR) to detect early caudal displacement of the device and to prevent type Ia endoleak. Methods: Four groups of elective EVAR patients were selected from a dataset purposely enriched with type Ia endoleak and migration (>10 mm) cases. The groups included cases of late type Ia endoleak (n=36), migration (n=9), a type II endoleak (n=16), and controls without post-EVAR complications (n=37). Apposition of the endograft fabric with the aortic neck, shortest distance between the fabric and the renal arteries, expansion of the main body (or dilatation of the aorta in the infrarenal sealing zone), and tilt of the endograft toward the aortic axis were determined on the first postoperative and the last available CTA scan without type Ia endoleak or migration. Differences in these endograft dimensions were compared between the first vs last scan and among the 4 groups. Results: No significant differences in endograft configurations were observed among the groups on the first postoperative CTA scan. On the last CTA scan before a complication arose, the position of the fabric relative to the renal arteries, expansion of the main body, and apposition of the fabric with the aortic neck were significantly different between the type Ia endoleak (median follow-up 15 months) and migration groups (median follow-up 23 months) compared with the control group (median follow-up 19 months). Most endograft dimensions had changed significantly compared with the first postoperative CTA scan for all groups. Apposition had increased in the control group but had decreased significantly in the type Ia endoleak and migration groups. Conclusion: Progressive changes in dimensions of the endograft within the infrarenal neck could be detected on regular CTA scans before the complication became urgent in many patients.",
keywords = "UT-Hybrid-D, aneurysm neck, type I endoleak, 3D imaging, stent-graft, endovascular aneurysm repair, migration, 3D reconstructions, endograft, geometry, abdominal aortic aneurysm",
author = "R.C.L. Schuurmann and {van Noort}, Kim and S.P. Overeem and {van Veen}, Ruben and Kenneth Ouriel and William Jordan and Bart Muhs and {'t Mannetje}, Yannick and Michel Reijnen and Bram Fioole and Cagdas Unlu and Peter Brummel and {de Vries}, J.P.P.M.",
note = "Sage deal",
year = "2018",
month = "6",
day = "1",
doi = "10.1177/1526602818764616",
language = "English",
volume = "25",
pages = "366--375",
journal = "Journal of Endovascular Therapy",
issn = "1526-6028",
publisher = "SAGE Publications",
number = "3",

}

Schuurmann, RCL, van Noort, K, Overeem, SP, van Veen, R, Ouriel, K, Jordan, W, Muhs, B, 't Mannetje, Y, Reijnen, M, Fioole, B, Unlu, C, Brummel, P & de Vries, JPPM 2018, 'Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair' Journal of Endovascular Therapy, vol. 25, no. 3, pp. 366-375. https://doi.org/10.1177/1526602818764616

Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair. / Schuurmann, R.C.L. (Corresponding Author); van Noort, Kim ; Overeem, S.P.; van Veen, Ruben; Ouriel, Kenneth; Jordan, William; Muhs, Bart; 't Mannetje, Yannick; Reijnen, Michel; Fioole, Bram; Unlu, Cagdas; Brummel, Peter; de Vries, J.P.P.M.

In: Journal of Endovascular Therapy, Vol. 25, No. 3, 01.06.2018, p. 366-375.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type Ia Endoleak and Migration After Endovascular Aneurysm Repair

AU - Schuurmann, R.C.L.

AU - van Noort, Kim

AU - Overeem, S.P.

AU - van Veen, Ruben

AU - Ouriel, Kenneth

AU - Jordan, William

AU - Muhs, Bart

AU - 't Mannetje, Yannick

AU - Reijnen, Michel

AU - Fioole, Bram

AU - Unlu, Cagdas

AU - Brummel, Peter

AU - de Vries, J.P.P.M.

N1 - Sage deal

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Purpose: To describe the added value of determining changes in position and apposition on computed tomography angiography (CTA) after endovascular aneurysm repair (EVAR) to detect early caudal displacement of the device and to prevent type Ia endoleak. Methods: Four groups of elective EVAR patients were selected from a dataset purposely enriched with type Ia endoleak and migration (>10 mm) cases. The groups included cases of late type Ia endoleak (n=36), migration (n=9), a type II endoleak (n=16), and controls without post-EVAR complications (n=37). Apposition of the endograft fabric with the aortic neck, shortest distance between the fabric and the renal arteries, expansion of the main body (or dilatation of the aorta in the infrarenal sealing zone), and tilt of the endograft toward the aortic axis were determined on the first postoperative and the last available CTA scan without type Ia endoleak or migration. Differences in these endograft dimensions were compared between the first vs last scan and among the 4 groups. Results: No significant differences in endograft configurations were observed among the groups on the first postoperative CTA scan. On the last CTA scan before a complication arose, the position of the fabric relative to the renal arteries, expansion of the main body, and apposition of the fabric with the aortic neck were significantly different between the type Ia endoleak (median follow-up 15 months) and migration groups (median follow-up 23 months) compared with the control group (median follow-up 19 months). Most endograft dimensions had changed significantly compared with the first postoperative CTA scan for all groups. Apposition had increased in the control group but had decreased significantly in the type Ia endoleak and migration groups. Conclusion: Progressive changes in dimensions of the endograft within the infrarenal neck could be detected on regular CTA scans before the complication became urgent in many patients.

AB - Purpose: To describe the added value of determining changes in position and apposition on computed tomography angiography (CTA) after endovascular aneurysm repair (EVAR) to detect early caudal displacement of the device and to prevent type Ia endoleak. Methods: Four groups of elective EVAR patients were selected from a dataset purposely enriched with type Ia endoleak and migration (>10 mm) cases. The groups included cases of late type Ia endoleak (n=36), migration (n=9), a type II endoleak (n=16), and controls without post-EVAR complications (n=37). Apposition of the endograft fabric with the aortic neck, shortest distance between the fabric and the renal arteries, expansion of the main body (or dilatation of the aorta in the infrarenal sealing zone), and tilt of the endograft toward the aortic axis were determined on the first postoperative and the last available CTA scan without type Ia endoleak or migration. Differences in these endograft dimensions were compared between the first vs last scan and among the 4 groups. Results: No significant differences in endograft configurations were observed among the groups on the first postoperative CTA scan. On the last CTA scan before a complication arose, the position of the fabric relative to the renal arteries, expansion of the main body, and apposition of the fabric with the aortic neck were significantly different between the type Ia endoleak (median follow-up 15 months) and migration groups (median follow-up 23 months) compared with the control group (median follow-up 19 months). Most endograft dimensions had changed significantly compared with the first postoperative CTA scan for all groups. Apposition had increased in the control group but had decreased significantly in the type Ia endoleak and migration groups. Conclusion: Progressive changes in dimensions of the endograft within the infrarenal neck could be detected on regular CTA scans before the complication became urgent in many patients.

KW - UT-Hybrid-D

KW - aneurysm neck

KW - type I endoleak

KW - 3D imaging

KW - stent-graft

KW - endovascular aneurysm repair

KW - migration

KW - 3D reconstructions

KW - endograft

KW - geometry

KW - abdominal aortic aneurysm

UR - http://www.scopus.com/inward/record.url?scp=85044783539&partnerID=8YFLogxK

U2 - 10.1177/1526602818764616

DO - 10.1177/1526602818764616

M3 - Article

VL - 25

SP - 366

EP - 375

JO - Journal of Endovascular Therapy

JF - Journal of Endovascular Therapy

SN - 1526-6028

IS - 3

ER -