Andrew England1, Francesco Torella2, Robert K Fisher2, Richard G McWilliams3. 1. Directorate of Radiography, University of Salford, Manchester, United Kingdom. Electronic address: a.england@salford.ac.uk. 2. Liverpool Vascular and Endovascular Service, Royal Liverpool Hospital National Health Service Trust, Liverpool, United Kingdom. 3. Department of Radiology, Royal Liverpool & Broadgreen University Hospitals National Health Service Trust, Liverpool, United Kingdom.
Abstract
BACKGROUND: This study reports the incidence and sequelae of migration of the Nellix (Endologix Inc, Irvine, Calif) endoprosthesis after endovascular aneurysm sealing. METHODS: A review was performed of the follow-up imaging of all endovascular aneurysm sealing patients in a university hospital endovascular program who had a minimum follow-up of 1 year. The first postoperative and latest follow-up computed tomography scans were used to measure the distances between the proximal and distal borders of the stent grafts relative to reference vessels using a previously validated technique. Device migration was based on previously established criteria and defined as any stent graft movement of ≥4 mm related to a predefined reference vessel. Device movement in a caudal direction was given a positive value, and movement in a cranial direction was denoted by a negative value. RESULTS: Eighteen patients (35 stent grafts) were eligible for inclusion in this retrospective review. The mean preoperative abdominal aortic aneurysm diameter was 57 mm (standard deviation [SD], 5; range, 50-67 mm) and aortic neck length was 30 mm (SD, 16; range, 6-62 mm). Proximal migration, according to study definitions, was identified in six stent grafts (17%), all in a caudal direction. At 1 year the mean proximal migration distance was +6.6 mm (SD, 1.6; range, +4.7-+9.2 mm). Migration occurred in a single stent graft in four patients and bilaterally in one. No distal migration occurred. CONCLUSIONS: Proximal migration of the Nellix endoprosthesis does occur and was without any sequelae in our series. Further investigations into the long-term positional stability of the Nellix device, together with a more thorough understanding of the etiology and consequences of migration, are required.
BACKGROUND: This study reports the incidence and sequelae of migration of the Nellix (Endologix Inc, Irvine, Calif) endoprosthesis after endovascular aneurysm sealing. METHODS: A review was performed of the follow-up imaging of all endovascular aneurysm sealingpatients in a university hospital endovascular program who had a minimum follow-up of 1 year. The first postoperative and latest follow-up computed tomography scans were used to measure the distances between the proximal and distal borders of the stent grafts relative to reference vessels using a previously validated technique. Device migration was based on previously established criteria and defined as any stent graft movement of ≥4 mm related to a predefined reference vessel. Device movement in a caudal direction was given a positive value, and movement in a cranial direction was denoted by a negative value. RESULTS: Eighteen patients (35 stent grafts) were eligible for inclusion in this retrospective review. The mean preoperative abdominal aortic aneurysm diameter was 57 mm (standard deviation [SD], 5; range, 50-67 mm) and aortic neck length was 30 mm (SD, 16; range, 6-62 mm). Proximal migration, according to study definitions, was identified in six stent grafts (17%), all in a caudal direction. At 1 year the mean proximal migration distance was +6.6 mm (SD, 1.6; range, +4.7-+9.2 mm). Migration occurred in a single stent graft in four patients and bilaterally in one. No distal migration occurred. CONCLUSIONS: Proximal migration of the Nellix endoprosthesis does occur and was without any sequelae in our series. Further investigations into the long-term positional stability of the Nellix device, together with a more thorough understanding of the etiology and consequences of migration, are required.
Authors: Thomas F X O'Donnell; Jeffrey P Carpenter; John S Lane; Jose Trani; Sajjad Hussain; Christopher Healey; Mahmoud B Malas; Marc L Schermerhorn Journal: Ann Vasc Surg Date: 2019-10-16 Impact factor: 1.466
Authors: Aleksandra C Zoethout; Johannes T Boersen; Jan M M Heyligers; Jean-Paul P M de Vries; Clark J A M Zeebregts; Michel M P J Reijnen Journal: J Endovasc Ther Date: 2018-03-29 Impact factor: 3.487
Authors: Aleksandra C Zoethout; Arshad Sheriff; Clark J Zeebregts; Michel M P J Reijnen; Andrew Hill; Andrew Holden Journal: J Endovasc Ther Date: 2020-09-10 Impact factor: 3.487