Studying the interaction of stent-grafts and treated abdominal aortic aneurysms: time to move caudally!

J Endovasc Ther. 2015 Jun;22(3):413-20. doi: 10.1177/1526602815583494.

Abstract

Since the advent of endovascular repair of aortic aneurysms (EVAR), clinical focus has been on preventing loss of sealing at the level of the infrarenal neck, which leads to type I endoleak and repressurization of the aneurysm sac. Enhanced mechanisms for central fixation and seal have consequently lowered the incidence of migration and endoleaks. However, endograft limb thrombosis and its causal mechanisms have not been addressed adequately in the literature. This article reviews the pathophysiological mechanisms associated with limb thrombosis in order to facilitate better clinical judgment to prevent iliac adverse effects.

Keywords: abdominal aortic aneurysm; endovascular aneurysm repair; graft limb; hemodynamics; iliac artery; iliac artery occlusion; stent-graft; thrombosis; tortuosity.

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / physiopathology
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Biomechanical Phenomena
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endoleak / etiology
  • Endoleak / physiopathology
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Hemodynamics
  • Humans
  • Iliac Artery / diagnostic imaging
  • Iliac Artery / physiopathology
  • Iliac Artery / surgery*
  • Prosthesis Design
  • Stents*
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Tomography, X-Ray Computed
  • Treatment Outcome