Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: A comparison of AneuRx and Zenith endografts Britt H. Tonnessen,

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Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: A comparison of AneuRx and Zenith endografts Britt H. Tonnessen, MD, W. Charles Sternbergh, MD, Samuel R. Money, MD Journal of Vascular Surgery Volume 42, Issue 3, Pages 392-401 (September 2005) DOI: 10.1016/j.jvs.2005.05.040 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 Freedom from migration (≥10 mm or clinical event) by Kaplan-Meier analysis. AneuRx freedom from migration was 96.1% ± 2.2%, 89.5% ± 3.8%, 78.0% ± 5.8%, 72.0% ± 6.8%, and 72.0 ± 6.8% at 1, 2, 3, 4, and 5 years. Zenith freedom from migration was 100% at 1 year and 97.6% ± 2.4% at 2, 3, and 4 years. Censored observations accounted for 19.5% to 38.5% of AneuRx and 20.8% to 42.3% of Zenith patients, depending on the selected time interval. Journal of Vascular Surgery 2005 42, 392-401DOI: (10.1016/j.jvs.2005.05.040) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Freedom from migration (≥5 mm) by Kaplan-Meier analysis. AneuRx freedom from migration was 89.6% ± 3.5%, 83.0% ± 4.5%, 73.5% ± 6.0%, 67.4% ± 6.9%, and 48.1% ± 9.8% at 1, 2, 3, 4, and 5 years. Zenith freedom from migration was 96.2% ± 2.6%, 93.8% ± 3.5%, 90.1% ± 5.0% and 90.1% ± 5.0% at 1, 2, 3, and 4 years. Censored observations accounted for 24.7% to 27.8% of AneuRx and 22.6% to 48.0% of Zenith patients, depending on the selected time interval. Journal of Vascular Surgery 2005 42, 392-401DOI: (10.1016/j.jvs.2005.05.040) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Axial computed tomography images 2 days (left) and 44 months (right) after endovascular aneurysm repair with an AneuRx endograft. The top frames show the top of the stent-graft, at the infrarenal position (left) and after migration of 14 mm (right). The bottom frames show comparable more caudal slices, with the interval development of a large type I endoleak (arrow) as a result of the migration. This patient represents the only case of delayed open conversion for migration in this series. Journal of Vascular Surgery 2005 42, 392-401DOI: (10.1016/j.jvs.2005.05.040) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 Number of patients treated and untreated for migration stratified by definition. Journal of Vascular Surgery 2005 42, 392-401DOI: (10.1016/j.jvs.2005.05.040) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 5 Cumulative aortic neck dilation over time after AneuRx or Zenith endograft. Aortic necks dilated more with Zenith than AneuRx endografts at 1 (0.9 ± 0.2 mm vs 0.3 ± 0.1 mm, P = .002), 2 (1.8 ± 0.2 mm vs 0.8 ± 0.2 mm, P < .0001), and 3 (1.9 ± 0.3 mm vs. 1.1 ± 0.2 mm, P = .03) years after endovascular aneurysm repair (EVAR), but were similar at 4 years after EVAR (1.9 mm ± 0.4 vs. 1.8 mm ± 0.3, P = .84).*Statistically significant. Journal of Vascular Surgery 2005 42, 392-401DOI: (10.1016/j.jvs.2005.05.040) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 6 Algorithm for the management of migration after endovascular aneurysm repair. Proximal fixation length may not be measurable with suprarenal fixation devices. Journal of Vascular Surgery 2005 42, 392-401DOI: (10.1016/j.jvs.2005.05.040) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions