Key result
Intraprocedural graft shortening ≥ 15 mm occurred in 56% of Vanguard and 44% of AneuRx endografts during endovascular AAA repair, requiring additional extension grafts in 14% of patients.
Why the study?
What is the incidence and extent of graft shortening during deployment of Vanguard or AneuRx self-expanding endovascular grafts in patients undergoing endovascular AAA repair?
Cohort (n=64)
What is the incidence and extent of graft shortening during deployment of Vanguard or AneuRx self-expanding endovascular grafts in patients undergoing endovascular AAA repair?
Self-expanding endoluminal grafts for AAA repair have a high incidence of intraprocedural shortening, which can lead to endoleaks requiring additional extension grafts.
Answers are grounded in this paper and cite their sources.
Frequent shortening with these grafts often requires extensions; leaves open whether modern devices reduce this in endovascular AAA repair.
Purpose: To evaluate the incidence and extent of length changes during implantation of endovascular grafts in a prospective study of patients undergoing endovascular abdominal aortic aneurysm (AAA) repair. Methods: Data regarding the occurrence of intraoperative technical difficulties and device complications were recorded prospectively for the Vanguard or AneuRx self-expanding, bifurcated endovascular grafts in 64 patients (56 males; mean age 75 years). Graft length was measured in the sheath system before deployment and again immediately after deployment by fluoroscopic comparison to a graduated marking catheter. Results: Graft shortening ≥ 15 mm was documented in 22 (56%) of 39 Vanguard cases and 11 (44%) of 25 AneuRx endografts. Additional extension grafts were required to correct endoleak caused by inadequate graft length in 9 (14%) patients, but no conversion to open repair was necessary. Conclusions: There appears to be a high incidence of intraprocedural graft shortening with 2 current designs of self-expanding endoluminal grafts.
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White et al. (1999) conducted a cohort in abdominal aortic aneurysm (AAA) (n=64). Vanguard or AneuRx self-expanding, bifurcated endovascular grafts was evaluated on Graft shortening ≥ 15 mm. Intraprocedural graft shortening ≥ 15 mm occurred in 56% of Vanguard and 44% of AneuRx endografts during endovascular AAA repair, requiring additional extension grafts in 14% of patients.
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