Systematic review and meta-analysis of migration after endovascular abdominal aortic aneurysm repair

Vascular. 2016 Jun;24(3):323-36. doi: 10.1177/1708538115590065. Epub 2015 Jun 8.

Abstract

Aim: To identify patients who are under higher threat for migration because of an old generation stent graft application.

Methods: A systematic review and meta-analysis of the literature was undertaken to identify all studies which included older generation endografts and data reporting on graft migration after EVAR. Outcome data were pooled and combined, and were calculated using fixed or random effects models.

Results: From 2000 to 2014, 22 retrospective studies were identified reporting on stent- graft migration after EVAR (8.6%). From those patients, 39% received re-intervention with the mean time of identification ranging from 12 to 36 months. Six of these retrospective nonrandomized studies were eligible for meta-analysis. AAA diameter (AAA diameter: 0.719 mm; 95% confidence interval [CI]: 0.00065-1.4384 mm; p = 0.00497) and neck length (neck length: 4.36 mm; 95% CI: 1.3277-7.394; p = 0.0048) were the only significant factors associated with stent- graft migration. Neck diameter and neck angulation did not have any important influence on stent-graft migration.

Conclusions: Patients with large AAA and short necks who were treated with older generation stent grafts such as AneurX and Talent are in higher risk for endograft migration than others. Stent- graft migration consists of an insidious and underestimated threat.

Keywords: Migration; aneurysm neck characteristics; endovascular aortic aneurysm repair.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis / adverse effects*
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / instrumentation
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology*
  • Foreign-Body Migration / surgery
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Reoperation
  • Risk Factors
  • Stents / adverse effects*
  • Treatment Outcome