Endovascular Treatment of Aorta-Iliac Aneurysms with a Flared Iliac Limb

Endovascular abdominal aneurysm repair (EVAR) relies on the quality of the proximal and distal landing zone. Reinterventions are higher in patients with suboptimal landing zone. The study aimed to evaluate reintervention rate after endovascular treatment of an aorta-iliac aneurysm using the flared iliac limbs.The retrospective study included 179 patients treated with EVAR at a single university hospital institution from January 2011 to January 2014 of which 75 patients (42%) were treated with flared iliac limb stent graft and 104 patients (58%) were treated with a nonflared iliac limb stent graft. There were 165 male patients (92%), mean age was 75.8 ± 6.6 years.Thirty-six patients underwent secondary treatment accounting for overall reintervention rate of 20%. Endoleak type 1b occurred in 13 patients (7%), followed by endoleak type 1a in six patients (3%). Endoleak type 2 occurred in seven patients (4%) requiring the treatment due to abdominal aortic aneurysm (AAA) enlargement, endoleak type 3 in three patients (2%), and leg stent graft thrombosis in seven patients (4%). In 143 patients (80%), there were no secondary interventions during the follow-up period. Reintervention due to endoleak type 1b was statistically significantly higher in a flared iliac limb group (p < 0.02) with the rate of 7.2% compared with 1.9% rate in nonflared iliac limb group. The mean follow-up was 44.3 ± 20.4. Overall mortality was 33%.Flared iliac limb with a distal diameter of ≥ 20 mm, show a higher rate of iliac limb reintervention in a follow-up period due to endoleak type 1b.

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Early Computed Tomographic Angiography after Endovascular Aneurysm Repair: Worthwhile or Worthless?

Vascular ◽

10.2310/6670.2008.00034 ◽

2008 ◽

Vol 16 (5) ◽

pp. 253-257 ◽

Cited By ~ 6

Author(s):

Evert J. Waasdorp ◽

Joost A. van Herwaarden ◽

Rob H.W. van de Mortel ◽

Frans L. Moll ◽

Jean-Paul P.M. de Vries

Keyword(s):

Stent Graft ◽

Endovascular Aneurysm Repair ◽

Computed Tomographic Angiography ◽

Type I ◽

Type Ii ◽

Graft Thrombosis ◽

Computed Tomographic ◽

Tomographic Angiography ◽

Aneurysm Repair

This study evaluated the value of computed tomographic angiography (CTA) early after an endovascular aneurysm repair (EVAR) in relation to CTA 3 months after EVAR. We retrospectively reviewed all elective EVAR patients with available postprocedural and 3-month follow-up CTAs who were treated between 1996 and 2006. CTAs were analyzed for EVAR-related complications in terms of endoleaks, migration, and stent graft thrombosis. Secondary procedures and other complications within a 4-month time interval after EVAR were noted and analyzed for any association with the postprocedural CTA. During the study period, 291 patients (275 men), with a mean age of 71 years, underwent elective EVAR. All had postprocedural and 3-month follow-up CTAs, which detected 93 (32%) endoleaks (8 type I, 84 type II, 1 type III) and 1 stent graft thrombosis. These findings resulted in four secondary interventions (one interposition cuff, two extension cuffs, one conversion). All reinterventions were successfully done in an elective setting. During the first 3 postoperative months, five other reinterventions were required for acute ischemia in four patients (three Fogarty procedures, one femorofemoral crossover bypass) or groin infection in one patient. Eight patients died, but none of the deaths were related to abdominal aortic aneurysm or EVAR (four cardiac, two pulmonary, one gastric bleeding, one carcinoma). At 3 months, 43 endoleaks (3 type I, 40 type II), 3 stent graft thromboses, and 1 stent graft migration were seen. In two patients (0.7%), a new endoleak was diagnosed compared with the postprocedural CTAs. In 287 (99%) of 291 patients, the postprocedural CTA did not influence our treatment policy in the first 3 months after EVAR. More than half of the early endoleaks were self-limiting, and new endoleaks were seen in only two patients (< 1%) at the 3-month follow-up CTA. After an uneventful EVAR procedure, it is safe to leave out the early postprocedural CTA.

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A systematic review of treatment modalities and outcomes of type Ib endoleak after endovascular abdominal aneurysm repair

Vascular ◽

10.1177/1708538117726468 ◽

2017 ◽

Vol 26 (1) ◽

pp. 90-98 ◽

Cited By ~ 7

Author(s):

Claudio Bianchini Massoni ◽

Paolo Perini ◽

Tiziano Tecchio ◽

Matteo Azzarone ◽

Alessandro de Troia ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Endovascular Treatment ◽

Treatment Modalities ◽

Iliac Aneurysm ◽

Abdominal Aneurysm ◽

Abdominal Aortic ◽

Buttock Claudication ◽

Aneurysm Repair

Objectives To collect specific literature on type Ib endoleak after aorto-iliac endografting for abdominal aortic aneurysm, reporting data on diagnosis, treatment, and follow-up results. Methods Publications about type Ib endoleak after aorto-iliac endografting for abdominal aortic or iliac aneurysm were searched in PubMed, Web of Science, and Scopus. Considered studies were in English and published until 3 November 2016. Research methods and reporting were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Inclusion criteria were: (1) reporting on abdominal aortic or iliac aneurysm as primary diagnosis; (2) reporting on distal endoleak after aorto-iliac endografting. Patient data, data on endovascular treatment, endoleak, reintervention, and follow-up were collected by two independent authors. Results Included studies were 11 (five original articles, six case reports), corresponding to 29 patients and 30 type Ib endoleak. Excluding missing data (2/30, 6.7%), type Ib endoleak was treated intra-operatively, within six months and after six months in six cases (21.4%), eight cases (28.6%), and fourteen cases (50%), respectively. Treatment of type Ib endoleak was endovascular in 27 cases (90%) (7 embolizations + extender cuffs, 10 extender cuffs, 8 embolizations without extender cuff, 1 Palmaz stenting and 1 iliac branched endograft), hybrid in 1 case (3.3%) and surgical in 2 cases (6.6%). Buttock claudication occurred in two cases (6.7%). One-month mortality was 3.4% (2/29) without events due to type Ib endoleak. In 14 cases (46.7%), median follow-up was six months (interquartile range: 2.75–14; range: 0.75–53). Type Ib endoleak persisted or reappeared in three cases (10%), all after endovascular treatment. Two of these (2/3, 66.7%) needed endovascular reintervention. No death during follow-up was reported. Conclusions Few specific data are available in literature about type Ib endoleak after aorto-iliac endografting for abdominal aortic aneurysm. About 50% of type Ib endoleak occurred after six months from the endovascular abdominal aneurysm repair procedure. Treatment is mainly endovascular and distal endograft extension is the main and effective treatment. Buttock claudication is the most frequent complication in case of exclusion of internal iliac artery. Persistent type Ib endoleak is possible, and adjunctive endovascular procedures are necessary.

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Outcomes of Advanta V12 Covered Stents After Fenestrated Endovascular Aneurysm Repair

Journal of Endovascular Therapy ◽

10.1177/15266028211016423 ◽

2021 ◽

pp. 152660282110164

Author(s):

Claire van der Riet ◽

Richte C. L. Schuurmann ◽

Eric L. G. Verhoeven ◽

Clark J. Zeebregts ◽

Ignace F. J. Tielliu ◽

...

Keyword(s):

Endovascular Aneurysm Repair ◽

Aortic Aneurysms ◽

Stent Fracture ◽

Covered Stents ◽

Significant Stenosis ◽

Primary Endpoints ◽

Visceral Arteries ◽

Aneurysm Repair ◽

Type 3

Purpose: Fenestrated endovascular aneurysm repair (FEVAR) is a well-established endovascular treatment option for pararenal abdominal aortic aneurysms in which balloon-expandable covered stents (BECS) are used to bridge the fenestration to the target vessels. This study presents midterm clinical outcomes and patency rates of the Advanta V12 BECS used as a bridging stent. Methods: All patients treated with FEVAR with at least 1 Advanta V12 BECS were included from 2 large-volume vascular centers between January 2012 and December 2015. Primary endpoints were freedom from all-cause reintervention, and freedom from BECS-associated complications and reintervention. BECS-associated complications included significant stenosis, occlusion, type 3 endoleak, or stent fracture. Secondary endpoints included all-cause mortality in-hospital and during follow-up. Results: This retrospective study included 194 FEVAR patients with a mean age of 72.2±8.0 years. A total of 457 visceral arteries were stented with an Advanta V12 BECS. Median (interquartile range) follow-up time was 24.6 (1.6, 49.9) months. The FEVAR procedure was technically successful in 93% of the patients. Five patients (3%) died in-hospital. Patient survival was 77% (95% CI 69% to 84%) at 3 years. Freedom from all-cause reintervention was 70% (95% CI 61% to 78%) at 3 years, and 33% of all-cause reinterventions were BECS associated. Complications were seen in 24 of 457 Advanta V12 BECSs: type 3 endoleak in 8 BECSs, significant stenosis in 4 BECSs, occlusion in 6 BECSs, and stent fractures in 3 BECSs. A combination of complications occurred in 3 BECSs: type 3 endoleak and stenosis, stent fracture and stenosis, and stent fracture and occlusion. The freedom from BECS-associated complications for Advanta V12 BECSs was 98% (95% CI 96% to 99%) at 1 year and 92% (95% CI 88% to 95%) at 3 years. The freedom from BECS-associated reinterventions was 98% (95% CI 95% to 100%) at 1 year and 94% (95% CI 91% to 97%) at 3 years. Conclusion: The Advanta V12 BECS used as bridging stent in FEVAR showed low complication and reintervention rates at 3 years. A substantial number of FEVAR patients required a reintervention, but most were not BECS related.

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Endovascular Aneurysm Sealing of a Collapsed and Thrombosed Aortic Stent-Graft With Renovisceral Chimney Stent-Grafts

Journal of Endovascular Therapy ◽

10.1177/1526602818811915 ◽

2018 ◽

Vol 26 (1) ◽

pp. 72-75

Author(s):

Fabien Lareyre ◽

Claude Mialhe ◽

Carine Dommerc ◽

Juliette Raffort

Keyword(s):

Stent Graft ◽

Mesenteric Artery ◽

Endovascular Aneurysm Repair ◽

Stent Grafts ◽

Aortic Thrombosis ◽

Aortic Stent Graft ◽

Aneurysm Repair ◽

Stent Graft Implantation ◽

Graft Implantation

Purpose: To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-year-old man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.

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Endovascular Aneurysm Sealing (EVAS) and Chimney EVAS in the Treatment of Failed Endovascular Aneurysm Repairs

Journal of Endovascular Therapy ◽

10.1177/1526602816675622 ◽

2016 ◽

Vol 24 (1) ◽

pp. 115-120 ◽

Cited By ~ 23

Author(s):

Marwan Youssef ◽

Sebastian Zerwes ◽

Rudolf Jakob ◽

Oroa Salem ◽

Fritz Dünschede ◽

...

Keyword(s):

Endovascular Aneurysm Repair ◽

Multiple Organ ◽

Aortic Aneurysms ◽

Technical Success ◽

Graft Thrombosis ◽

Type Ia ◽

Aneurysm Repair ◽

Chimney Graft ◽

Bifurcated Graft

Purpose: To assess the technical success and clinical outcome of reinterventions using the Nellix Endovascular Aneurysm Sealing (EVAS) System to treat complications after endovascular aneurysm repair (EVAR). Methods: Fifteen consecutive patients (mean age 79 years; 14 men) with prior EVAR were treated with EVAS between March 2014 and December 2015 at 2 institutions. The failed prior EVARs included 13 bifurcated endografts, 1 bifurcated graft plus fenestrated cuff, and 1 tube endograft. Endoleaks were the predominant indications: type Ia in 10 and type III in 5 (3 type IIIa and 2 type IIIb). All patients presented with progressive aortic aneurysms (median 7.85-cm diameter; range 6.5–11). Eight patients were treated on an urgent or emergency basis (6 symptomatic aneurysms and 2 contained ruptures). All patients underwent Nellix relining of the failed stent-graft; 10 had chimney (Ch) procedures in combination with EVAS (chEVAS) because the proximal landing zones were inadequate. Results: Technical success was 100%. All endoleaks were successfully sealed, and no additional intervention was required. No further endoleak after EVAS or chEVAS was recorded. Endobag protrusion occurred in 1 case without sequelae. One elderly patient with ruptured aneurysm died from multiple organ failure 2 months postoperatively. One renal artery guidewire injury led to nephrectomy because of active bleeding. No reinterventions, aneurysm-related mortalities, graft thrombosis, endoleaks, or chimney graft occlusions were observed during a median follow-up of 8 months (range 3–24). Conclusion: The present preliminary experience demonstrates that the use of EVAS/chEVAS is feasible for treatment of failed EVAR. This technique may be used as bailout or an alternative treatment when other established methods are infeasible or not available.

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Endovascular repair of aortic aneurysm: Preliminary results

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0902010d ◽

2009 ◽

Vol 137 (1-2) ◽

pp. 10-17 ◽

Cited By ~ 1

Author(s):

Lazar Davidovic ◽

Momcilo Colic ◽

Igor Koncar ◽

Dejan Markovic ◽

Dusan Kostic ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Stent Graft ◽

Endovascular Aneurysm Repair ◽

Aortic Aneurysms ◽

Endovascular Stent ◽

Stent Grafts ◽

Graft Thrombosis ◽

Abdominal Aortic

Introduction. Endovascular aneurysm repair (EVAR) has been introduced into clinical practice at the beginning of the 90's of the last century. Because of economic, political and social problems during the last 25 years, the introduction of this procedure in Serbia was not possible. Objective. The aim of this study was to present preliminary experiences and results of the Clinic for Vascular Surgery of the Serbian Clinical Centre in Belgrade in endovascular treatment of thoracic and abdominal aortic aneurysms. Methods. The procedure was performed in 33 patients (3 female and 30 male), aged from 42 to 83 years. Ten patients had a descending thoracic aorta aneurysm (three atherosclerotic, four traumatic - three chronic and one acute as a part of polytrauma, one dissected, two penetrated atherosclerotic ulcers), while 23 patients had the abdominal aortic aneurysm, one ruptured and two isolated iliac artery aneurysms. The indications for EVAR were isthmic aneurismal localisation, aged over 80 years and associated comorbidity (cardiac, pulmonary and cerebrovasular diseases, previous thoracotomy or multiple laparotomies associated with abdominal infection, idiopatic thrombocitopaenia). All of these patients had three or more risk factors. The diagnosis was established using duplex ultrasonography, angiography and MSCT. In the case of thoracic aneurysm, a Medtronic-Valiant? endovascular stent graft was implanted, while for the abdominal aortic aneurysm Medtronic-Talent? endovascular stent grafts with delivery systems were used. In three patients, following EVAR a surgical repair of the femoral artery aneurysm was performed, and in another three patients femoro-femoral cross over bypass followed implantation of aortouniiliac stent graft. Results. During procedure and follow-up period (mean 1.6 years), there were: one death, one conversion, one endoleak type 1, six patients with endoleak type 2 that disappeared during the follow-up period, one early graft thrombosis. No other complications, including aneurysm expansion, collapse, deformity and migration of the endovascular stent grafts, were registered. Conclusion. According to all medical and economic aspects, we recommend EVAR to treat acute traumatic thoracic aortic aneurysm, as well as in elderly and high-risk patients with abdominal or thoracic aneurysms, when open surgery is related to a significantly higher mortality and morbidity.

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Five-year survival after elective open and endovascular aortic aneurysm repair

Scandinavian Journal of Surgery ◽

10.1177/14574969211048707 ◽

2021 ◽

pp. 145749692110487

Author(s):

Jüri Lieberg ◽

Karl G. Kadatski ◽

Mart Kals ◽

Kaido Paapstel ◽

Jaak Kals

Keyword(s):

Aortic Aneurysm ◽

Survival Data ◽

Endovascular Aneurysm Repair ◽

National Registry ◽

University Hospital ◽

Current Evidence ◽

Term Survival ◽

All Cause Mortality ◽

Aneurysm Repair

Background and objective: Current evidence suggests short-term survival benefit from endovascular aneurysm repair (EVAR) versus open surgical repair (OSR) in elective abdominal aortic aneurysm (AAA) procedures, but this benefit is lost during long-term follow-up. The aim of this study was to compare short- and mid-term all-cause mortality in patients with non-ruptured aneurysm treated by OSR and EVAR; and to assess the rate of complications and reinterventions, as well as to evaluate their impact on survival. Methods: The medical records of the non-ruptured AAA patients undergoing OSR or EVAR between 1 January 2011 and 31 December 2019 at Tartu University Hospital, Estonia, were retrospectively reviewed. We gathered survival data from the national registry (mean follow-up period was 3.7 ± 2.3 years). Results: A total of 225 non-ruptured AAA patients were treated operatively out of whom 95 (42.2%) were EVAR and 130 (57.8%) were OSR procedures. The difference in estimated all-cause mortality between the OSR and EVAR groups at day 30 was statistically irrelevant (2.3% vs 0%; p = 0.140), but OSR patients showed statistically significantly higher 5 year survival compared with EVAR patients (75.3% vs 50.0%, p = 0.002). Complication and reintervention rates for the EVAR and OSR groups did not differ statistically (26.3% vs 16.9%, p = 0.122; 10.5% vs 11.5%, p = 0.981, respectively). Multivariate analysis revealed that greater aneurysm diameter (p = 0.012), EVAR procedure (p = 0.016), male gender (p = 0.023), and cerebrovascular diseases (p = 0.028) were independently positively associated with 5-year mortality. Conclusions: Thirty-day mortality, and complication and reintervention rates for EVAR and OSR after elective AAA repair were similar. Although the EVAR procedure is an independent risk factor for 5-year mortality, higher age and greater proportion of comorbidities among EVAR patients may influence not only the choice of treatment modality, but also prognosis.

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Review of postoperative CT and ultrasound for endovascular aneurysm repair using Talent stent graft: Can we simplify the surveillance protocol and reduce the number of CT scans?

Acta Radiologica ◽

10.1258/ar.2012.110291 ◽

2013 ◽

Vol 54 (1) ◽

pp. 54-58 ◽

Cited By ~ 11

Author(s):

Thomas Nyheim ◽

Lars Erik Staxrud ◽

L Rosen ◽

Carl Erik Slagsvold ◽

Gunnar Sandbæk ◽

...

Keyword(s):

Stent Graft ◽

Mixed Model ◽

Endovascular Aneurysm Repair ◽

Plain Film ◽

Ct Scans ◽

X Rays ◽

Time Sensitivity ◽

Surveillance Protocol ◽

Aneurysm Repair

Background Simplifying a postoperative surveillance protocol for endovascular aneurysm repair (EVAR) requires quality control comparing computerized tomography (CT) and ultrasound (US) results of abdominal aortic aneurysm (AAA) diameter measurements and endoleaks. Purpose To test if US is comparable to CT, then assess a simplified follow-up with our conventional surveillance to assess patient safety. Material and Methods During 2001-2006, data on 56 patients treated with Talent stent graft were prospectively registered. Median follow-up was 41.5 months (range, 2-94 months), with CT, US, and plain film abdomen X-rays (PFA) at 1, 6, and 12 months, then yearly. Bland-Altman plot was used to assess the agreement between CT and US measuring the AAA diameters and mixed model by the time effect to assess the difference in diameter over time. Sensitivity and specificity for detection of endoleaks by US, with CT as ‘gold standard’ were calculated. A simplified surveillance protocol with US/PFA at 6 and 8 weeks, CT/US/PFA at 1 year, and yearly US/PFA thereafter, was evaluated. CT was carried out when poor visibility, endoleak detected, AAA diameter increase (≥5 mm) on US or migration (≥10 mm) on PFA. This regime was compared with our conventional follow-up protocol. Results Diameter measurements on US appear comparable to CT with 91% specificity and 85% sensitivity for endoleaks detected by US. Using the simplified surveillance protocol no endoleaks, migrations, or endotension requiring treatment were overlooked. The simplified protocol generated 53 selective CT scans, avoiding approximately 144 CT scans. If further simplified by omitting the 1-year CT scan, one type II endoleak would be missed with a 1-year delay, eliminating a further 45 CT scans. Conclusion US appears comparable to CT in the follow-up of Talent stent grafts in our institution. The proposed simplified surveillance protocol seems safe and can lead to a significant reduction in the number of CT scans.

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Type IIIb Endoleak After Endovascular Aneurysm Repair Using the Zenith Stent Graft

Vascular and Endovascular Surgery ◽

10.1177/1538574419858824 ◽

2019 ◽

Vol 53 (6) ◽

pp. 515-519

Author(s):

Toshiya Nishibe ◽

Toru Iwahashi ◽

Kentaro Kamiya ◽

Masaki Kano ◽

Keita Maruno ◽

...

Keyword(s):

Stent Graft ◽

Endovascular Aneurysm Repair ◽

Aneurysm Rupture ◽

Type I ◽

Stent Grafts ◽

System Type ◽

Type Iiib ◽

Type I Endoleak ◽

Aneurysm Repair

We present 3 cases of type IIIb endoleak after endovascular aneurysm repair (EVAR) using the Zenith stent graft system. Type III endoleak, like type I endoleak, is a high-pressure, high-risk leak that increases sac pressure up to or even above arterial pressure, and is associated with an increased frequency of open conversions or risk of aneurysm rupture. Type IIIb endoleak is rare but there is much concern that the incidence of type IIIb endoleak is likely to increase hereafter; the mechanism of type IIIb endoleak is deterioration of graft fabric in conjunction with stent sutures. Type IIIb endoleak is difficult to diagnose before rupture. The possibility of type IIIb endoleak should be highly suspected when the continued growth of an excluded aneurysm sac without direct radiologic evidence is observed during follow-up. Type IIIb endoleak can be repaired by relining of the stent graft with additional stent grafts.

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The Evaluation of Aortic Diameter Changes During Long-Term Follow-Up After Endovascular Treatment of Acute Blunt Traumatic Thoracic Aortic Injuries

Vascular and Endovascular Surgery ◽

10.1177/1538574418765385 ◽

2018 ◽

Vol 52 (5) ◽

pp. 335-343 ◽

Cited By ~ 6

Author(s):

Federico Fontana ◽

Edoardo Macchi ◽

Filippo Piacentino ◽

Larissa Nocchi Cardim ◽

Giuseppe De Marchi ◽

...

Keyword(s):

Endovascular Treatment ◽

Stent Graft ◽

Mean Value ◽

Aortic Diameter ◽

Long Term Results ◽

Technical Success ◽

Long Term Follow Up ◽

Aortic Injuries

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.

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