Thromboembolic complications after treatment with the INCRAFT abdominal aortic aneurysm ultra-low-profile stent graft system.

IF 3.9 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Journal of Vascular Surgery Pub Date : 2025-01-10 DOI:10.1016/j.jvs.2025.01.004
Dimitrios D Papazoglou, Mathieu Béguin, Mario Ricchiuto, Salome Weiss, Silvan Jungi, Michel Bosiers, Drosos Kotelis, Vladimir Makaloski
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Abstract

Objective: Low-profile endografts have reported increased rates of limb graft occlusions. The INCRAFT stent graft system is an ultra-low-profile endograft for the exclusion of infrarenal abdominal aortic aneurysms. Our aim was to report thromboembolic events (TEs) in patients treated with the INCRAFT device and its association with risk factors.

Methods: A retrospective study was performed of 80 patients treated with the INCRAFT endograft between February 2015 and December 2022 at a single institution. All available imaging studies were reviewed by two reviewers independently. TEs included intraprosthetic thrombus (IPT), limb graft occlusion (LGO), and distal embolization. A regression analysis was performed to evaluate possible risk factors associated with the development of TEs. These included tortuous access vessels, IPT, access vessel diameter, and the ratio between the cross-sectional area of the main body to the bilateral limb grafts.

Results: Limb occlusions occurred in seven patients (9%) and 12 limbs (7.5%), resulting in a primary and secondary patency at 1, 3, and 5 years of 96% and 99%, 94% and 97%, and 89% and 93%, respectively. IPT was found in 36% of patients and affected endograft limbs in 93%. Ten distal occlusions in eight patients (10.0%) were considered to originate from IPT, which led to symptomatic occlusions of below-the-knee vessels in all patients. Freedom from IPT at 1, 3, and 4 years was 80%, 61%, and 43%, respectively. Age ≤70 years and access vessel diameter ≥10 mm were associated with IPT development. IPT was significantly associated with LGO (odds ratio, 77.10; P = .003).

Conclusions: Thromboembolic events are frequent after treatment with the INCRAFT endograft with a LGO rate of 9% per patient and IPT found in 36% of patients. IPT was more common in patients ≤70 years and was a significant risk factor for LGO.

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INCRAFT AAA超低轮廓支架系统治疗后的血栓栓塞并发症。
目的:据报道,低姿态的内移植物增加了肢体移植物闭塞的发生率。INCRAFT支架移植系统是一种超低轮廓的内移植物,用于排除肾下腹主动脉瘤。我们的目的是报告使用INCRAFT装置治疗的患者的血栓栓塞事件(TE)及其与危险因素的关联。方法:对2015年2月至2022年12月在同一医院接受INCRAFT内移植物治疗的80例患者进行回顾性研究。所有可用的影像学研究均由两名独立审稿人进行审查。TE包括假体内血栓(IPT)、肢体移植物闭塞(LGO)和远端栓塞。进行回归分析以评估与TE发展相关的可能危险因素。这些指标包括通路血管曲度、IPT、通路血管直径和主体与双侧肢体移植物的横截面积之比。结果:肢体闭塞7例(9%),肢体闭塞12例(7.5%),1年、3年、5年原发和继发通畅率分别为96%和99%,94%和97%,89%和93%。36%的患者存在IPT, 93%的患者存在移植物肢体受损。8例患者(10.0%)的10例远端闭塞被认为起源于IPT,这导致所有患者的膝下血管出现症状性闭塞。1年、3年和5年的IPT自由度分别为80%、61%和43%。年龄≤70岁,导管直径≥10 mm与IPT的发生有关。IPT与LGO有显著相关性(OR 77.10, p=0.003)。结论:使用INCRAFT内移植物治疗后,血栓栓塞事件频繁发生,肢体移植物闭塞率为9% /例,IPT发生率为36% /例。IPT在≤70岁的患者中更为常见,是LGO的重要危险因素。
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来源期刊
CiteScore
7.70
自引率
18.60%
发文量
1469
审稿时长
54 days
期刊介绍: Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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