Thrombus Formation in Aortic Endografts

• Published in: Journal of endovascular therapy 2001-08, Vol.8 (4), p.372-379
• Main Authors: Wegener, Martin, Görich, Johannes, Krämer, Stefan, Fleiter, Thorsten, Tomczak, Reinhard, Scharrer-Pamler, Reinhard, Kapfer, Xaver, Brambs, Hans-Jürgen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anatomy, Cross-Sectional; Aortic Aneurysm - complications; Aortic Aneurysm - surgery; Blood Vessel Prosthesis - adverse effects; Blood Vessel Prosthesis Implantation; Extremities - anatomy & histology; Extremities - blood supply; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Thrombosis - diagnosis; Thrombosis - etiology; Time Factors; Tomography, X-Ray Computed; Vascular Surgical Procedures
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1177/152660280100800406

Purpose: To examine the incidence of intraprosthetic thrombotic deposits in aortic endografts. Methods: Transfemoral implantation of tube or bifurcated stent-grafts was performed in 82 patients (75 men; average age 67.7 years, range 25–88) for treatment of aneurysms of the abdominal (n = 73) or thoracic (n = 9) aorta in a 3.5-year period. Patients underwent 3-phase helical computed tomographic (CT) examinations at 3-month intervals. The length and cross-sectional area of any thrombotic deposits were measured from axial and 3-dimensional CT images. Results: Over a 12.1-month mean follow-up, intraluminal deposits of thrombotic material were observed in 19 (23.2%) patients, all with infrarenal endografts that were predominately of a bifurcated design. The first signs of thrombus formation occurred on average 7 months postoperatively (range 1 week to 20 months). In 16 patients, nonocclusive deposits of thrombotic material were seen in the aortic segment of the endograft; a graft limb was involved in 5 patients. Three graft limbs occluded owing to kinking; no thrombus was seen on CT scans taken prior to occlusion. In 3 cases the thrombotic deposits disappeared completely from the prosthesis lumen during follow-up. Conclusions: Based on this small experience, nearly 1 in 5 patients may experience some degree of intraluminal thrombus following endovascular treatment of aortic aneurysms. Whether the deposition of thrombus is influenced by the geometry of the aortic stent-graft or by flow conditions within the prosthetic lumen must be determined in future studies.