Abdominal Aortic Aneurysmatic Sac Shrinking is the New Paradigm after Endovascular Treatment

Abstract

Objectives: Aneurysmal Sac (SAC) absorption after endovascular treatment (EVAR) of Abdominal Aortic Aneurysms (AAA) is related to a better prognosis but its long-term mandatory and predictive factors remain unclear. Our study aims to assess the impact of its total resorption on patient survival, as well as the factors that favor resorption. Methods: We followed a187 patients who underwent EVAR with a fully thrombosed SAC for 22 years in the postoperative control of Angio-CT. We established the significance of the factors for SAC resorption by logistic regression models, evaluating comorbidities, diameter, sex and age of the patient. We also compared the impact of absorption sac absorption with survival. Results: Diameter and age were significant for the resorption of the SAC together or even independently (p-value <0.001), the diameter (OR-0.29) showed a greater influence than age (OR= -0.063). The comorbidities studied and the sex of the patients was not statistically significant. Patients who had significant absorption (≥ 10 mm) had a survival rate of 12.72 ± 0.96 years, those with moderate absorption (5 mm to 9 mm) had of 8.34 ± 1.62 years and those without significant resorption or growth had 3.27 ± 0.48 years (p-value <0.001). Among patients with absorption of ≥ 5 mm in the first year, we found greater chances of total absorption (OR=4.72 p-value <0.001). Conclusion: Total sac resorption proved to be an important prognostic factor for patient survival after EVAR. The age of the patient and mainly the initial diameter of the sac were the factors significantly associated with the resorption of the sac.