Deshpande Amit Ajit, Pandey Niraj Nirmal, Shaw Manish, Kumar Sanjeev, Jagia Priya, Sharma Sanjiv, Choudhary Shiv
Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India.
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
Indian J Radiol Imaging. 2022 Jul 31;32(3):324-331. doi: 10.1055/s-0042-1754317. eCollection 2022 Sep.
Migration of the stent-graft post-thoracic endovascular aortic repair (TEVAR) is not uncommon; however, it is sparsely reported. The objective of this study was to assess the incidence, risk factors, and complications of stent-graft migration post-TEVAR. Thirty-one patients who underwent TEVAR were retrospectively analyzed. The demographic, anatomical, and procedure-related factors were assessed. The measurements were done along the greater curvature of aorta around two fixed anatomic landmarks, that is, left common carotid artery or neoinnominate artery (hybrid repair) proximally and celiac artery distally. Aortic elongation and migration at proximal, distal, as well as at overlapping zone were measured. More than 10 mm of migration was considered significant. Significant migration was observed in six (19%) patients. No significant migration was observed in the overlapping zone. The proximal landing zone 3 (odds ratio [OR] 12.78, 0.01) was a significant risk factor, whereas landing zone 2 was a protective factor against the migration (OR 0.08, 0.02). The odds for migration were more in segments I/3 and II/3 compared with I/2 and II/2, respectively, as per Modified Arch Landing Areas Nomenclature. A single complication was seen in the migration group which was treated by an overlapping stent graft. The stent-graft migration after TEVAR is not uncommon. Type 3 proximal landing zone was a significant risk factor for migration with an increased risk toward I/3 and II/3. Proximal landing zone 2 as well as adequate overlapping distance in multiple stent grafts can prevent migration. IECPG-227/24.06.2020.
胸主动脉腔内修复术（TEVAR）后支架移植物的迁移并不罕见；然而，相关报道却很少。本研究的目的是评估TEVAR后支架移植物迁移的发生率、危险因素和并发症。
对31例行TEVAR的患者进行了回顾性分析。评估了人口统计学、解剖学和手术相关因素。测量沿着主动脉大弯在两个固定解剖标志周围进行，即近端的左颈总动脉或新无名动脉（杂交修复）和远端的腹腔干动脉。测量主动脉在近端、远端以及重叠区域的伸长和迁移情况。超过10毫米的迁移被认为是显著的。
6例（19%）患者出现显著迁移。在重叠区域未观察到显著迁移。近端着陆区3（优势比[OR]12.78，P<0.01）是一个显著的危险因素，而着陆区2是防止迁移的保护因素（OR 0.08，P<0.02）。根据改良主动脉弓着陆区命名法，与I/2和II/2相比，I/3和II/3节段的迁移几率更高。迁移组出现1例并发症，通过重叠支架移植物进行了治疗。
TEVAR后支架移植物迁移并不罕见。近端3型着陆区是迁移的显著危险因素，I/3和II/3节段的风险增加。近端着陆区2以及多个支架移植物中足够的重叠距离可防止迁移。
IECPG - 227/24.06.2020
