Ces radiol. 2023, 77(1):12-16 | DOI: 10.55095/CesRadiol2023/002

Development of the proximal neck after endovascular treatment of abdominal aortic aneurysm in long-term follow-upOriginal article

Marie Černá1, Pavel Jemelka1, Martin Köcher1, Petr Utíkal2, Petr Dráč2, Vojtěch Prášil1
1 Radiologická klinika LF UP a FN, Olomouc
2 II. chirurgická klinika LF UP a FN, Olomouc

Aim: To evaluate the development of the proximal neck of an abdominal aorticaneurysm in long-term follow-up in patients after endovascular treatment withstent graft in relation to possible complications.

Method: Patients after stent graft implantation (Zenith Flex, Zenith LP, Ella)for abdominal aortic aneurysm from 2004 to 2017. The proximal neck wasmeasured on CT angiography in 236 patients (35 women, 201 men). The diameterof the proximal neck before stent graft implantation, in the follow-up afterimplantation and the occurrence of complications (stent graft migration, typeI endoleak) were evaluated. Neck dilatation was defined as an increase indiameter of more than 2.5 mm compared to follow-up CT angiography one yearafter implantation. Student?s paired t-test was used for statisticalprocessing.

Results: Dilation of the neck occurred during follow-up in 69 patients(29.2%). The neck diameter increased significantly in the first 6 years offollow-up. Proximal neck dilatation occurred more frequently with Ella stentgrafts (Ella 34.5%, Zenith Flex 20.2%). The incidence of migration and type Iendoleak was significantly higher in patients with proximal neck dilatationduring follow-up (t-test 0.029).

Conclusion: Early progressive dilation of the proximal neck occurs after astent graph implantation for an abdominal aortic aneurysm. In patients with aneck dilatation is a higher incidence stent graft migration caudally andendoleak type I.

Keywords: abdominal aortic aneurysm, stentgraft, proximal neck, neckdilatation

Published: March 1, 2023  Show citation

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Černá M, Jemelka P, Köcher M, Utíkal P, Dráč P, Prášil V. Development of the proximal neck after endovascular treatment of abdominal aortic aneurysm in long-term follow-up. Ces radiol. 2023;77(1):12-16. doi: 10.55095/CesRadiol2023/002.
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    References

    1. Howard DPJ, Marron CD, Sideso E, et al. Influence of Proximal Aortic Neck Diameter on Durability of Aneurysm Sealing and Overall Survival in Patients Undergoing Endovascular Aneurysm Repair. Real World Data from the Gore Global Registry for Endovascular Aortic Treatment (GREAT). J Vasc Surg 2018; 68(3) Go to original source...
    2. -199.
    3. Filis KA, Galyfos G, Sigala F, et al. Proximal Aortic Neck Progression: Before and After Abdominal Aortic Aneurysm Treatment. Frontiers in Surgery 2017 Go to original source...
    4. (23): 1-6. 3. Kouvelos GN, Oikonomou K, Antoniou GA, Verhoeven ELG, Katsargyris A. A Systematic Review of Proximal Neck Dilatation After Endovascular Repair for Abdominal Aortic Aneurysm. J Endovasc Ther 2017; 24(1): 59-67.
    5. AbuRahma AF, Campbell J, Stone PA, et al. The correlation o f aortic neck length to early and late outcomes in endovascular aneurysm repair. J Vasc Surg 2009; 50(4): 738-748. Go to original source... Go to PubMed...
    6. Leurs LJ, Kievit J, Dagnelie PC, et al. Influence of infrarenal neck length on outcome of endovascular abdominal aortic aneurysm repair. J Endovasc Ther 2006; 13(5): 640-648. Go to original source... Go to PubMed...
    7. Stanley BM, Semmens JB, Jai Q, et al. Evaluation of patient selection guidelines for endoluminal AAA repair with the Zenith stent-graft: the Australasian experience. J Endovasc Ther 2001; 8(5): 457-464. Go to original source... Go to PubMed...
    8. Sternbergh 3rd WC, Carter G, York JW, et al. Aortic neck angulation predicts adverse outcome with endovascular abdominal aortic aneurysm repair. J Vasc Surg 2002; 35(3): 482-486. Go to original source... Go to PubMed...
    9. Černá M, Köcher M, Utíkal P. Pozdní komplikace a reintervence po implantaci stentgraftu pro subrenalní aneuryzma břišní aorty. Ces Radiol 2012; 66(2): 159-165.
    10. Köcher M, Utíkal P, Koutná J, et al. Endovascular treatment of abdominal aortic aneurysms 6 years of experience with Ella stent-graft system. Eur J Radiol 2004; 51(2): 181-188. Go to original source... Go to PubMed...
    11. May J, White GH, Ly GH, et al. Endoluminal repair of abdominal aortic aneurysm prevents enlargement of the proximal neck (a 9-year life-table and I-year longitudinal study). J Vasc Surg 2003; 37(1): 86-90. Go to original source... Go to PubMed...
    12. Cao P, Verzini F, Parlani G, et al. Predictive factors and clinical consequences of proximal aortic neck dilatation in 230 patients undergoing abdominal aorta aneurysm repair with self-expandable stent-grafts. J Vasc Surg 2003; 37(6): 1200-1205. Go to original source... Go to PubMed...
    13. Badran MF, Gould DA, Raza I. Aneurysm Neck Diameter after Endovascular Repair of Abdominal Aortic Aneurysms. J Vasc Interv Radiol 2002; 13(9): 887-892. Go to original source... Go to PubMed...
    14. Kaladji A, Cardon A, Laviolle B, Heautot J-F, et al. Evolution of the upper and lower landing site after endovascular aortic aneurysm repair. J Vasc Surg 2012; 55(1): 24-32. Go to original source... Go to PubMed...
    15. Kret MR, Tran K, Lee JT. Change in Aortic Neck Diameter after Endovascular Aortic Aneurysm Repair. Ann Vasc Surg 2017; 43: 115-120. Go to original source... Go to PubMed...
    16. Lee WA, Brown MP, Nelson PR, Huber TS. Total percutaneous access for endovascular aortic aneurysm repair (Preclose" technique). J Vasc Surg 2007; 45(6): 1095-1101. Go to original source... Go to PubMed...
    17. Oberhuber A, Schwarz A, Hoffmann MH, et al. Influence of Different Self-Expanding Stent Graft Types on Remodeling of the Aortic Neck After Endovascular Aneurysm Repair. J Endovasc Ther 2010; 17(6): 677-684. Go to original source... Go to PubMed...
    18. Soberon AB, de Garcia MM, Moll GG, et al. Follow-Up of Aneurysm Neck Diameter after Endovascular Repair of Abdominal Aortic Aneurysms. Ann Vasc Surg 2008; 22(4): 559-563. Go to original source... Go to PubMed...
    19. Oberhuber A, Buecken M, Hoffmann M, Orend KH, Muhling BM. Comparison of aortic neck dilatation after open and endovascular repair of abdominal aortic aneurysm. J Vasc Surg 2012; 55(4): 929-934. Go to original source... Go to PubMed...
    20. Tsilimparis N, Dayama A, Ricotta JJ. Remodeling of aortic aneurysm and aortic neck on follow-up after endovascular repair with suprarenal fixation. J Vasc Surg 2015; 61(1): 28-34. Go to original source... Go to PubMed...

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