Mural Thrombotic Deposits in Abdominal Aortic Endografts Are Common and Do Not Require Additional Treatment at Short-term and Midterm Follow-up

Abstract

To assess the incidence and clinical significance of thrombotic, nonocclusive mural deposits in abdominal aortic stent-grafts incidentally found on follow-up computed tomography scans after endovascular aneurysm repair (EVAR). Between 1998 and 2007, 288 patients underwent EVAR of an infrarenal aortic aneurysm. In the majority of cases, a Zenith stent-graft (n = 187) or Excluder stent-graft (n = 71) was implanted. Clinical and radiologic follow-up was performed prospectively according to the EUROSTAR registry, with mean follow-up periods of 4.69 and 5.05 years, respectively, for the Excluder and Zenith groups. Thrombotic deposits were found in 17% and 33% of patients in the Excluder and Zenith groups, respectively, which represents a significant difference (P = .038). Clinically, no distal atheroembolic events were noted during follow-up, and there was no significant difference in survival between patients with and without thrombotic deposits (P = .80). Incidentally found thrombotic deposits in abdominal aortic endografts are common and device-specific, with a lower incidence in the Excluder group versus the Zenith group. These thrombotic deposits are clinically silent, do not require additional treatment at short-term and midterm follow-up, and do not affect the overall survival of the treated patients.