Joep A W Teijink1, Adam H Power2, Dittmar Böckler3, Patrick Peeters4, Steven van Sterkenburg5, Lee H Bouwman6, Hence J Verhagen7, Marc Bosiers8, Vincente Riambau9, Jean-Pierre Becquemin10, Philippe Cuypers11, Marc van Sambeek11. 1. Catharina Hospital Eindhoven, Eindhoven, the Netherlands. Electronic address: joep.teijink@cze.nl. 2. Western University, London, Ontario, Canada. 3. University Hospital Heidelberg, Heidelberg, Germany. 4. Imelda Hospital Bonheiden, Bonheiden, Belgium. 5. Rijnstate Hospital Arnhem, Arnhem, the Netherlands. 6. Zuyderland Medisch Centrum Heerlen, Heerlen, the Netherlands. 7. Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands. 8. AZ Sint-Blasius Campus Dendermonde, Dendermonde, Belgium. 9. Hospital Clinic Barcelona, Barcelona, Spain. 10. Institut Vasculaire Paris Est, Hopital Privé Paul d'Egine, Ramsay Group Champigny, Champigny, France. 11. Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
Abstract
OBJECTIVE/ BACKGROUND: Endovascular abdominal aortic aneurysm repair (EVAR) is commonly used to treat abdominal aortic aneurysm (AAA). However, the incidence of long-term complications and the need for re-interventions after EVAR remain a concern. Newer generation stent grafts have encouraging short and mid-term outcomes, but thorough analysis of their long-term performance is necessary. METHODS: The ENGAGE registry includes a total of 1263 patients with AAA enrolled from March 2009 to April 2011 at 79 centres across 30 countries. The aim of this study is to present standard EVAR outcomes in the registry after five years. RESULTS: A significant proportion of the ENGAGE patients presented with challenging features, such as 15.2% with an AAA diameter >7 cm, 12.0% with proximal neck lengths <15 mm, and 10.2% with infrarenal neck angles >60°. Of the 1263 enrolled subjects, 17.8% were implanted outside of the instructions for use for the device. At the five year follow up, the Kaplan-Meier overall survival rate was 67.4% and the freedom from aneurysm related mortality was 97.8%. Freedom from aneurysm rupture, secondary procedures, and conversion to open repair at five years were 98.6%, 84.3%, and 97.9% respectively. The five year freedom from type IA endoleaks was 95.2% and for type III endoleaks 97.4%. Aneurysm sac diameter at five years was observed to have either decreased ≥5 mm in diameter or remained stable in 89.4% of the patients. CONCLUSION: Five year follow up of patients in the ENGAGE registry demonstrates sustained safety, effectiveness, and durability in an international cohort that is reflective of real world experience. Additional follow up is expected through to 10 years.
OBJECTIVE/ BACKGROUND:Endovascular abdominal aortic aneurysm repair (EVAR) is commonly used to treat abdominal aortic aneurysm (AAA). However, the incidence of long-term complications and the need for re-interventions after EVAR remain a concern. Newer generation stent grafts have encouraging short and mid-term outcomes, but thorough analysis of their long-term performance is necessary. METHODS: The ENGAGE registry includes a total of 1263 patients with AAA enrolled from March 2009 to April 2011 at 79 centres across 30 countries. The aim of this study is to present standard EVAR outcomes in the registry after five years. RESULTS: A significant proportion of the ENGAGE patients presented with challenging features, such as 15.2% with an AAA diameter >7 cm, 12.0% with proximal neck lengths <15 mm, and 10.2% with infrarenal neck angles >60°. Of the 1263 enrolled subjects, 17.8% were implanted outside of the instructions for use for the device. At the five year follow up, the Kaplan-Meier overall survival rate was 67.4% and the freedom from aneurysm related mortality was 97.8%. Freedom from aneurysm rupture, secondary procedures, and conversion to open repair at five years were 98.6%, 84.3%, and 97.9% respectively. The five year freedom from type IA endoleaks was 95.2% and for type III endoleaks 97.4%. Aneurysm sac diameter at five years was observed to have either decreased ≥5 mm in diameter or remained stable in 89.4% of the patients. CONCLUSION: Five year follow up of patients in the ENGAGE registry demonstrates sustained safety, effectiveness, and durability in an international cohort that is reflective of real world experience. Additional follow up is expected through to 10 years.
Authors: Ertekin Utku Ünal; Hakkı Zafer İscan; Bekir Bogachan Akkaya; İsa Civelek; Mehmet Karahan; Ece Celikten; Göktan Askin; Hayrettin Levent Mavioğlu; Mehmet Ali Özatik Journal: Kardiochir Torakochirurgia Pol Date: 2021-05-15
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