Distal migration of stent-grafts after endovascular repair of abdominal aortic aneurysms

Tim Resch, Krassi Ivancev, J Brunkwall, Ulf Nyman, Martin Malina, Bengt Lindblad

Research output: Contribution to journalArticlepeer-review


PURPOSE: To analyze patients after endovascular repair of abdominal aortic aneurysm (AAA) with respect to distal migration of stent-grafts and its underlying causes. MATERIALS AND METHODS: Sixty-five patients underwent endovascular repair between January 1994 and February 1997. There were seven women and 58 men, with a mean age of 71 years (range, 51-84 years). Three patients died in the perioperative period (one of myocardial infarction and two of multiorgan failure) and two patients died within 4 months of the procedure of non-procedure-related causes. In addition, two patients were followed at another hospital. The remaining 58 patients were followed up with spiral computed tomography scans at 1, 3, and 6 months, and biannually thereafter. Angiography was performed at 1 month and 1 year after the procedure and additionally when deemed clinically necessary. Mean follow-up was 29 months (range, 1-49). Migration more than 5 mm was considered significant. RESULTS: Twenty-six patients (45%) showed distal migration of stent-grafts during follow-up. Mean follow-up time at detection of migration was 13 months (range, 1-36 months). Thirteen cases of migration were ascribed to dilatation of the proximal aneurysmal neck during follow-up. Ten cases of migration were ascribed to causes other than neck dilatation or poor patient selection. In three cases, no obvious cause for the migration was found. The migration was complete in eight cases, leading to late conversion to open surgical repair. On two of these occasions, complete migration lead to aneurysm rupture. In addition, four patients received additional stent-grafts as proximal extensions. CONCLUSIONS: Distal migration of stent-grafts after endovascular AAA repair occurred frequently in this series. Dilatation of the proximal aneurysmal neck is a major cause of distal migration of stent-grafts. Improved proximal fixation is needed to secure long-term durability.
Original languageEnglish
Pages (from-to)257-264
JournalJournal of Vascular and Interventional Radiology
Issue number3
Publication statusPublished - 1999

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Unit for Clinical Vascular Disease Research (013242410), Emergency medicine/Medicine/Surgery (013240200), Medical Radiology Unit (013241410)

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems
  • Radiology, Nuclear Medicine and Medical Imaging
  • Clinical Medicine


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