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J Endovasc Surg. 1997 Feb;4(1):23-30.

Changing aneurysmal morphology after endovascular grafting: relation to leakage or persistent perfusion.

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1
Department of Vascular Surgery, Malmö University Hospital, Lund University, Sweden.

Abstract

PURPOSE:

To relate changing abdominal aortic aneurysm (AAA) morphology after endovascular grafting to the presence of leakage, collateral perfusion, and other factors.

METHODS:

Thirty-five patients who underwent successful AAA endovascular grafting were evaluated. Self-expanding Z-stents and Dacron grafts were applied in bifurcated and aortomonoiliac systems. Postoperative diameter changes were calculated from repeated spiral computed tomographic scans, angiograms, and ultrasonic phase-locked echo-tracking scans during a median 6-month follow-up (interquartile range [IQR] 3 to 12).

RESULTS:

At 12 months, the diameters of completely excluded aneurysms had decreased 6 mm (IQR 2 to 11; p = 0.006). The proximal graft-anchoring stents had dilated 2 mm (IQR 0.5 to 3.3; p = 0.01). The aortic diameters immediately below the renal arteries but above the stents had not changed. Endoleakage and collateral perfusion (n = 13) were each associated with preserved aneurysm size and a 12 times higher risk of aneurysm dilation. After the leakage or the collateral perfusion had been treated, the aneurysm size decreased. Aneurysms with extensive intraluminal thrombi presented a reduced risk of leakage or perfusion.

CONCLUSIONS:

The diameters of endovascularly excluded AAAs decrease, except in cases of leakage or perfusion. Careful follow-up of patients with aortic endografts is necessary.

[Indexed for MEDLINE]

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