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).

• Authors: Masahiro Okada, Nobuhiro Handa, Toshihiro Onohara, Minoru Okamoto, Tsuyoshi Yamamoto, Yasushi Shimoe, Masafumi Yamashita, Toshiki Takahashi, Jyunji Kishimoto, Akihiro Mizuno, Junichi Kei, Mikizou Nakai, Masayuki Sakaki, Hitoshi Suhara, Fuminori Kasashima, Masamitsu Endo, Takeshi Nishina, Tadashi Furuyama, Masakazu Kawasaki, Keiji Iwata, Akira Marumoto, Yasuhisa Urata, Katsutoshi Sato, Masahiro Ryugo, National Hospital Organization Network Study Group for Abdominal Aortic Aneurysm in Japan
• Journal: Annals of vascular diseases (Ann Vasc Dis) Vol. 9 Issue 2 Pg. 102-7 ( 2016) ISSN: 1881-641X [Print] Japan
• PMID: 27375803 (Publication Type: Journal Article)