Purpose: To evaluate the incidence and extent of length changes during impl
antation of endovascular grafts in a prospective study of patients undergoi
ng endovascular abdominal aortic aneurysm (AAA) repair.
Methods: Data regarding the occurrence of intraoperative technical difficul
ties and device complications were recorded prospectively for the Vanguard
or AneuRx self-expanding, bifurcated endovascular grafts in 64 patients (56
males; mean age 75 years). Graft length was measured in the sheath system
before deployment and again immediately after deployment by fluoroscopic co
mparison to a graduated marking catheter.
Results: Graft shortening greater than or equal to 15 mm was documented in
22 (56%) of 39 Vanguard cases and 11 (44%) of 25 AneuRx endografts. Additio
nal extension grafts were required to correct endoleak caused by inadequate
graft length in 9 (14%) patients, but no conversion to open repair was nec
essary.
Conclusions: There appears to be a high incidence of intraprocedural graft
shortening with 2 current designs of self-expanding endoluminal grafts.