Mid-term fixation stability of the EndoVascular Technologies endograft

Aim of the study: to determine the positional stability of the EndoVascular Technologies (EVT) endograft after endovascular aneurysm repair during morphologic changes of the abdominal aorta during follow-up. Patients and methods: all patients treated worldwide with an EVT endograft with an adequate postoperative and at least 12 months postoperative CT scan were included (n = 125). Endograft migration was investigated by recording the position of the endograft attachment systems relative to the renal arteries and the aortic or iliac bifurcations. The vertical body axis served as a scale to quantify migration. Aortic cross-sectional areas were measured in the suprarenal aorta and in the proximal and distal aneurysm necks. Length changes of the infrarenal aorta during follow-up were measured, comparing the distance between the left renal artery and the aortic bifurcation. Results: the median follow-up was 24 months (range 12-48 months). Graft migration was identified in 4 out of 125 patients (3%). Significant infrarenal aortic dilation was observed at the proximal and distal aneurysm neck during follow-up. However, aortic neck dilation was not associated with endograft migration. The length of the infrarenal aorta did not change significantly after endovascular repair. Conclusion: fixation by stents containing hooks of the EVT design appear to be effective in preventing migration of endografts with an unsupported trunk for up to four years. A stable position was maintained in spite of changes in cross-sectional areas of the aneurysm neck.