Source:http://linkedlifedata.com/resource/pubmed/id/15696248
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
1
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pubmed:dateCreated |
2005-2-7
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pubmed:abstractText |
Long-term success of endovascular aneurysm repair (EVAR) relies on a stable proximal neck. The authors' goal was to determine whether neck dilatation after EVAR varies among 4 different endografts and whether it is related to complications of the proximal neck. Core laboratory data from 4 phase II trials of aortic endografts were analyzed for neck diameter changes over time. Patients who had at least 24 months' follow-up were included in the analysis. Neck measurement methodology varied among the 3 core labs used. Values are reported within the parameters used by each lab. Short-axis neck diameter close to 5 mm below the renal arteries, when available, was used for longitudinal comparisons. Dilation was defined as an enlargement of 3 mm or more from the first postoperative scan to the last available follow-up for each patient. Graft migration and late proximal endoleaks were determined by the individual core labs. A limited number of Lifepath grafts had most recent follow-up measurements performed by the authors. Results were compared by using Student's t test, chi-square analysis, and the Pearson correlation coefficient. Postoperative measurements from 729 EVAR patients were examined. Follow-up ranged from 24 to 60 months for 229 Ancure (Guidant) and 258 AneuRx (Medtronic) patients, and from 24 to 36 months for 211 Excluder (Gore) and 31 first-generation Lifepath (Edwards) patients. Neck dilation was noted in 124 patients (17.0%) and did not differ significantly among graft types. The incidences of late proximal endoleaks were similar among graft types, but rates of migration differed (p=0.01). Dilation was associated with migration in Ancure (p=0.03) and Excluder (p=0.02) grafts. Late proximal endoleaks were seen in 4.1% of patients with and in 0.7% of patients without dilation (p=0.001). Patients with initial neck diameter >25 mm had significantly less dilatation than those with smaller necks (p<0.001). The incidence of neck dilation approached 20% in all EVAR patients after 24 months and was not significantly different among graft types. Neck dilation of 3 mm or more appears to be one risk factor for migration and late proximal endoleak.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:issn |
1538-5744
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
39
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
47-54
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pubmed:dateRevised |
2007-11-15
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pubmed:meshHeading |
pubmed-meshheading:15696248-Aortic Aneurysm, Abdominal,
pubmed-meshheading:15696248-Blood Vessel Prosthesis,
pubmed-meshheading:15696248-Blood Vessel Prosthesis Implantation,
pubmed-meshheading:15696248-Clinical Trials, Phase II as Topic,
pubmed-meshheading:15696248-Dilatation, Pathologic,
pubmed-meshheading:15696248-Disease Progression,
pubmed-meshheading:15696248-Foreign-Body Migration,
pubmed-meshheading:15696248-Humans,
pubmed-meshheading:15696248-Incidence,
pubmed-meshheading:15696248-Prosthesis Failure,
pubmed-meshheading:15696248-Vascular Diseases
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pubmed:articleTitle |
Is neck dilatation after endovascular aneurysm repair graft dependent? Results of 4 US Phase II trials.
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pubmed:affiliation |
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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pubmed:publicationType |
Journal Article,
Comparative Study
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