{"doi":"10.1093/ejcts/ezaf198","title":"Anatomic predictors of distal landing zone failure after endovascular repair of thoracic aortic aneurysm","abstract":"OBJECTIVES: To analyse anatomic factors of the distal landing zone (dLZ) associated with the durability of endovascular repair of thoracic aortic aneurysm (TAA). METHODS: Consecutive patients undergoing thoracic endovascular aortic repair (TEVAR) for undissected TAA were queried from a single centre from 2004 to 2022. Patient and operative factors were considered as well as detailed anatomic factors at the dLZ assessed by 3D reconstruction of pre-TEVAR imaging. The outcome of interest was the long-term risk of TEVAR failure at the dLZ. RESULTS: A total of 101 patients undergoing TEVAR repair of TAA were considered, of whom 17 suffered distal TEVAR failure over a median follow-up period of 2.7 years. Two anatomic factors showed outsized influence on long-term outcomes: dLZ diameter and dLZ length (the length of non-dilated aortic tissue above the coeliac artery). Patients who progressed to distal TEVAR failure had larger dLZ diameter (34.2 mm vs 30.7 mm, P = 0.034) and far shorter dLZ length (3.8 cm vs 7.5 cm, P = 0.008). Patients with dLZ diameter greater than 35 mm had much greater risk of mortality or distal TEVAR failure within 2 years (34% vs 5%, P = 0.012), as did those with dLZ length less than 4 cm (27% vs 6%, P = 0.006). CONCLUSIONS: In this study, mild dilation at the dLZ beyond 35 mm and short length at the dLZ less than 4 cm are both clear anatomic risk factors for poor long-term outcome after supraceliac TEVAR. It may be appropriate to consider repair via branched endografts landing beyond the coeliac artery in patients with these risk factors.","journal":"European Journal of Cardio-Thoracic Surgery","year":2025,"id":536404,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9536,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1421727,"name":"A Peev","orcid":null,"position":1,"is_corresponding":false},{"id":1421228,"name":"Peter Auteri","orcid":"0000-0001-8796-0829","position":2,"is_corresponding":false},{"id":318255,"name":"Grace J. Wang","orcid":"0000-0003-3241-9669","position":3,"is_corresponding":false},{"id":1421229,"name":"Kendall M. Lawrence","orcid":"0000-0002-2698-5720","position":4,"is_corresponding":false},{"id":768128,"name":"Alexandra Sperry","orcid":"0000-0003-1741-7147","position":5,"is_corresponding":false},{"id":1261027,"name":"Mikołaj Berezowski","orcid":"0000-0002-8493-6169","position":6,"is_corresponding":false},{"id":1261026,"name":"Murat Yıldız","orcid":"0000-0001-7371-6892","position":7,"is_corresponding":false},{"id":1261028,"name":"Waseem Lutfi","orcid":"0000-0001-8327-4127","position":8,"is_corresponding":false},{"id":1069643,"name":"John DePaolo","orcid":"0000-0002-6829-2594","position":9,"is_corresponding":false},{"id":954023,"name":"Yu Zhao","orcid":"0000-0003-2219-0661","position":10,"is_corresponding":false},{"id":881083,"name":"Alexander S. Fairman","orcid":"0000-0001-8737-7334","position":11,"is_corresponding":false},{"id":881533,"name":"Wilson Y. Szeto","orcid":null,"position":12,"is_corresponding":false},{"id":881084,"name":"Darren B. Schneider","orcid":"0009-0001-4414-1580","position":13,"is_corresponding":false},{"id":243353,"name":"Nimesh D. Desai","orcid":"0000-0002-4456-5674","position":14,"is_corresponding":false},{"id":1191290,"name":"Nicholas Goel","orcid":"0000-0001-8210-5815","position":0,"is_corresponding":true}],"reference_count":15,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:52:05.227140Z","pmid":"40693300","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}