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Incomplete endograft apposition to the aortic arch: bird-beak configuration increases risk of endoleak formation after thoracic endovascular aortic repair.

Publication ,  Journal Article
Ueda, T; Fleischmann, D; Dake, MD; Rubin, GD; Sze, DY
Published in: Radiology
May 2010

PURPOSE: To determine the clinical importance of the bird-beak configuration after thoracic endovascular aortic repair (TEVAR). MATERIALS AND METHODS: The institutional review board approved this retrospective study and waived the requirement to obtain informed consent from patients. Sixty-four patients (40 men, 24 women; mean age, 64 years) who underwent TEVAR were evaluated. The treated diseases included dissection (n = 29), degenerative aneurysm (n = 13), acute traumatic transection (n = 8), pseudoaneurysm (n = 4), penetrating aortic ulcer (n = 6), intramural hematoma (n = 2), and mycotic aneurysm (n = 2). Bird-beak configuration, defined as the incomplete apposition of the proximal endograft with a wedge-shaped gap between the device and the aortic wall, was assessed with postprocedural CT angiography. The presence and length of the bird-beak configuration were compared with the formation of endoleaks and adverse clinical events. RESULTS: Endoleaks were detected in 26 (40%) of the 64 patients, including 14 with type Ia endoleak formation, one with type Ib endoleak formation, six with type II endoleak formation (from the left subclavian artery), two with type IIo endoleak formation (from other arteries), and three with type III endoleak formation. Bird-beak configuration was observed in 28 (44%) of 64 patients and correlated significantly with the risk of developing a type Ia or IIa endoleak (P < .01). Mean bird-beak length was significantly longer (P < .01) in patients with a type Ia or II endoleak (mean length, 14.3 and 13.9 mm, respectively) than in patients without endoleaks (mean length, 8.4 mm). Adverse events included early aortic-related death in three patients, additional treatment for endoleak in eight patients, and stent-graft collapse or infolding in six patients. CONCLUSION: Detection of bird-beak configuration is helpful in the prediction of adverse clinical events after TEVAR.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

May 2010

Volume

255

Issue

2

Start / End Page

645 / 652

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Prosthesis Failure
  • Postoperative Complications
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Contrast Media
 

Citation

APA
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ICMJE
MLA
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Ueda, T., Fleischmann, D., Dake, M. D., Rubin, G. D., & Sze, D. Y. (2010). Incomplete endograft apposition to the aortic arch: bird-beak configuration increases risk of endoleak formation after thoracic endovascular aortic repair. Radiology, 255(2), 645–652. https://doi.org/10.1148/radiol.10091468
Ueda, Takuya, Dominik Fleischmann, Michael D. Dake, Geoffrey D. Rubin, and Daniel Y. Sze. “Incomplete endograft apposition to the aortic arch: bird-beak configuration increases risk of endoleak formation after thoracic endovascular aortic repair.Radiology 255, no. 2 (May 2010): 645–52. https://doi.org/10.1148/radiol.10091468.
Ueda, Takuya, et al. “Incomplete endograft apposition to the aortic arch: bird-beak configuration increases risk of endoleak formation after thoracic endovascular aortic repair.Radiology, vol. 255, no. 2, May 2010, pp. 645–52. Epmc, doi:10.1148/radiol.10091468.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

May 2010

Volume

255

Issue

2

Start / End Page

645 / 652

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Prosthesis Failure
  • Postoperative Complications
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Humans
  • Female
  • Contrast Media