Advances in the study of morphological evaluation of the landing zone and clinical outcomes in endovascular aortic aneurysm repair
Objective To summarize the research progress of relationship between distal landing zone geometric and outcomes of endovascular aortic aneurysm repair(EVAR)for abdominal aortic aneurysm.Methods The domestic and foreign literature on the accumulation of the impact of proximal and distal landing zone geometric morphology on clinical outcomes,the evaluation methods for related complications of proximal and distal landing zones,preventive measures for adverse outcomes related to the geometric morphology of the distal landing zone,and the pathophysiological mechanisms of complications related to the distal landing zone were retrieved to make an review.Results The irregular geometric morphology of the proximal landing zone was closely associated with adverse events following EVAR.The morphology of the distal landing zone was actually more complex than that of the proximal zone,and the measurement methods for its parameters were also more complicated.Common methods used in the literature for studying landing zones included the centerline distance method,the minimum distance method,and the landing area method.Primary preventive measures for adverse outcomes related to the geometry of the distal landing zone included increasing radial support force and contact area,using endostaples,and extending the landing zone.In addition to anatomical factors,the distal landing zone was also influenced by various pathophysiological factors.Conclusions The morphology and related pathological changes of the distal landing zone significantly impact the clinical outcomes following EV AR for abdominal aortic aneurysm.However,current research on the distal landing zone is limited.Future studies should focus on developing new technologies and methods to improve the evaluation and management of the distal landing zone,thereby reducing the complications after EVAR,enhancing the success rate of the surgery,and improving patient survival quality.
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