Late Sac Behavior after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm

Abstract

Background: Sac behavior after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is considered as a surrogate for the risk of late rupture. The purpose of the study is to assess the sac behavior of AAAs after EVAR. Methods and Results: Late sac enlargement (LSE) (≥5 mm) and late sac shrinkage (LSS) (≥5 mm) were analyzed in 589 consecutive patients who were registered at 14 national centers in Japan. The proportions of patients who had LSE at 1, 3 and 5 years were 2.6% ± 0.7%, 10.0% ± 1.6% and 19.0% ± 2.9%. The proportions of patients who had LSS at 1, 3 and 5 years were 50.1% ± 0.7%, 59.2% ± 2.3% and 61.7% ± 2.7%. Multiple logistic regression analysis identified two variables as a risk factor for LSE; persistent endoleak (Odds ratio 9.56 (4.84-19.49), P <0.001) and low platelet count (Odds ratio 0.92 (0.86-0.99), P = 0.0224). The leading cause of endoleak in patients with LSE was type II. Conclusions: The incidence of LSE is not negligible over 5 year period. Patients with persistent endoleak and/or low platelet count should carefully be observed for LSE. Clinical Trial Registration: UMIN-CTR (UMIN000008345).

Aneurysmal Sac Dynamics as a Marker of Long-Term Results in Patients after EVAR

“…Некоторыми авторами показатель динамики размеров аневризматического мешка предложен как один из маркеров успешности EVAR [9][10][11][12][13][14], и логично предположить, что пациенты, показывающие позитивную динамику, находятся в группе меньшего риска негативных событий и, как следствие, могут не требовать столь интенсивного наблюдения. В некоторых публикациях раннее сокращение размеров мешка было определено как уменьшение диаметра >5 мм в течение 1 года после EVAR по сравнению с тем, что наблюдалось в предоперационном периоде по данным МСКТ [15,16].…”