PURPOSE: We aimed to identify the risk factors associated with late aneurysmal sac expansion after endovascular abdominal aortic aneurysm repair (EVAR). METHODS: We retrospectively reviewed contrast-enhanced computed tomography (CT) images of 143 patients who were followed for ≥6 months after EVAR. Sac expansion was defined as an increase in sac diameter of 5 mm relative to the preoperative diameter. Univariate and multivariate analyses were performed to identify associated risk factors for late sac expansion after EVAR from the following variables: age, gender, device, endoleak, antiplatelet therapy, internal iliac artery embolization, and preprocedural variables (aneurysm diameter, proximal neck diameter, proximal neck length, suprarenal neck angulation, and infrarenal neck angulation). RESULTS: Univariate analysis revealed female gender, endoleak, aneurysm diameter ≥60 mm, suprarenal neck angulation >45°, and infrarenal neck angulation >60° as factors associated with sac expansion. Multivariate analysis revealed endoleak, aneurysm diameter ≥60 mm, and infrarenal neck angulation >60° as independent predictors of sac expansion (P < 0.05, for all). CONCLUSION: Our results suggest that patients with small abdominal aortic aneurysms (<60 mm) and infrarenal neck angulation ≤60° are more favorable candidates for EVAR. Intraprocedural treatments, such as prophylactic embolization of aortic branches or intrasac embolization, may reduce the risk of sac expansion in patients with larger abdominal aortic aneurysms or greater infrarenal neck angulation.
PURPOSE: We aimed to identify the risk factors associated with late aneurysmal sac expansion after endovascular abdominal aortic aneurysm repair (EVAR). METHODS: We retrospectively reviewed contrast-enhanced computed tomography (CT) images of 143 patients who were followed for ≥6 months after EVAR. Sac expansion was defined as an increase in sac diameter of 5 mm relative to the preoperative diameter. Univariate and multivariate analyses were performed to identify associated risk factors for late sac expansion after EVAR from the following variables: age, gender, device, endoleak, antiplatelet therapy, internal iliac artery embolization, and preprocedural variables (aneurysm diameter, proximal neck diameter, proximal neck length, suprarenal neck angulation, and infrarenal neck angulation). RESULTS: Univariate analysis revealed female gender, endoleak, aneurysm diameter ≥60 mm, suprarenal neck angulation >45°, and infrarenal neck angulation >60° as factors associated with sac expansion. Multivariate analysis revealed endoleak, aneurysm diameter ≥60 mm, and infrarenal neck angulation >60° as independent predictors of sac expansion (P < 0.05, for all). CONCLUSION: Our results suggest that patients with small abdominal aortic aneurysms (<60 mm) and infrarenal neck angulation ≤60° are more favorable candidates for EVAR. Intraprocedural treatments, such as prophylactic embolization of aortic branches or intrasac embolization, may reduce the risk of sac expansion in patients with larger abdominal aortic aneurysms or greater infrarenal neck angulation.
Authors: J Habets; H J A Zandvoort; J B Reitsma; L W Bartels; F L Moll; T Leiner; J A van Herwaarden Journal: Eur J Vasc Endovasc Surg Date: 2013-02-09 Impact factor: 7.069
Authors: Thomas J Ward; Stuart Cohen; Aaron M Fischman; Edward Kim; Francis S Nowakowski; Sharif H Ellozy; Peter L Faries; Michael L Marin; Robert A Lookstein Journal: J Vasc Interv Radiol Date: 2013-01 Impact factor: 3.464
Authors: Frank J Veith; Richard A Baum; Takao Ohki; Max Amor; Mohan Adiseshiah; Jan D Blankensteijn; Jacob Buth; Timothy A M Chuter; Ronald M Fairman; Geoffrey Gilling-Smith; Peter L Harris; Kim J Hodgson; Brian R Hopkinson; Krassi Ivancev; Barry T Katzen; Michael Lawrence-Brown; George H Meier; Martin Malina; Michel S Makaroun; Juan C Parodi; Götz M Richter; Geoffrey D Rubin; Wolf J Stelter; Geoffrey H White; Rodney A White; Willem Wisselink; Christopher K Zarins Journal: J Vasc Surg Date: 2002-05 Impact factor: 4.268
Authors: Jason T Lee; Ihab N Aziz; James T Lee; Jason S Haukoos; Carlos E Donayre; Irwin Walot; George E Kopchok; Mauricio Lippmann; Rodney A White Journal: J Vasc Surg Date: 2003-12 Impact factor: 4.268
Authors: Sarah E Deery; Emel A Ergul; Marc L Schermerhorn; Jeffrey J Siracuse; Andres Schanzer; Philip P Goodney; Richard P Cambria; Virendra I Patel Journal: J Vasc Surg Date: 2017-08-31 Impact factor: 4.268