Aortic neck enlargement after endovascular aneurysm repair using balloon-expandable versus self-expanding endografts Janis Savlovskis, MD, Dainis Krievins,

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Aortic neck enlargement after endovascular aneurysm repair using balloon-expandable versus self-expanding endografts Janis Savlovskis, MD, Dainis Krievins, MD, PhD, Jean-Paul P.M. de Vries, MD, PhD, Andrew Holden, MD, Kaspars Kisis, MD, Marcis Gedins, MD, Natalija Ezite, MD, Christopher K. Zarins, MD Journal of Vascular Surgery Volume 62, Issue 3, Pages 541-549 (September 2015) DOI: 10.1016/j.jvs.2015.04.393 Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 1 Location of aortic diameter measurements on preimplant and postimplantation computed tomography (CT) scans in patients treated with balloon-expandable stent (BES) and self-expandable stent (SES) endografts. The suprarenal aortic diameter was measured just below the superior mesenteric artery. The infrarenal aortic neck diameter was measured at just below the lowermost renal artery (level 1), at the proximal end of the endograft (level 2), and 5 mm below the proximal end of the endograft (level 3). The infrarenal neck length and covered neck length were derived as shown. Journal of Vascular Surgery 2015 62, 541-549DOI: (10.1016/j.jvs.2015.04.393) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 2 Histograms show suprarenal aorta and infrarenal aortic neck (level 3) diameter distribution before, after, and 3 years after endovascular aneurysm repair (EVAR). Significant infrarenal aortic neck enlargement is present at 3 years in self-expanding stent (SES) patients compared with balloon-expandable stent (BES) patients. Journal of Vascular Surgery 2015 62, 541-549DOI: (10.1016/j.jvs.2015.04.393) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 3 Representative examples are shown of the change in infrarenal aortic neck diameter over time after treatment with balloon-expandable stent (BES) and self-expandable stent (SES) endografts. Cross-section of infrarenal aorta 5 mm below the proximal end of endograft (level 3) is shown for BES at (A) baseline, (B) postoperatively, and (C) at 3 years, and for SES at (D) baseline, (E) postoperatively, and (F) at 3 years. Note: The extrastent contrast seen on the postoperative and 3-year BES scan is within the polymer filled endobags surrounding the stents. Journal of Vascular Surgery 2015 62, 541-549DOI: (10.1016/j.jvs.2015.04.393) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 4 Change in diameter of suprarenal aorta and infrarenal aortic neck over time after treatment with balloon-expandable stent (BES) and self-expandable stent (SES) endografts. ANCOVA, Analysis of covariance; CI, confidence interval. Journal of Vascular Surgery 2015 62, 541-549DOI: (10.1016/j.jvs.2015.04.393) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 5 Aortic diameter changes over time after treatment with balloon-expandable stent (BES) and self-expandable stent (SES) endografts. After BES implantation, there was no significant change in suprarenal or infrarenal aortic diameter. After SES implantation, there was significant infrarenal aortic neck enlargement but no change in suprarenal aortic diameter. ANCOVA, Analysis of covariance; CI, confidence interval. Journal of Vascular Surgery 2015 62, 541-549DOI: (10.1016/j.jvs.2015.04.393) Copyright © 2015 Society for Vascular Surgery Terms and Conditions