One Year Outcome Using Newer Generation Endografts: A National Multicenter Study on Real Word Practice

Abstract

Background The aim of this study was to assess the 1 year outcomes following endovascular aortic aneurysm repair (EVAR) with the use of newer generation endografts. Methods Retrospective analysis was conducted of prospectively collected multicenter data from 385 EVARs. Newer endografts were defined as those introduced after 2004. Patients' demographics and comorbidities, type of operation, and abdominal aortic aneurysm (AAA) morphological characteristics were analyzed. Computer tomography was performed 1 month and 1 year post-EVAR. Results Mean age of the patients was 71.3 years; in 335 cases the intervention was elective. The mean AAA sac, neck diameter, and length were 57.15, 24.5, and 28.97 mm, respectively. Ninety-four endoleaks were recorded in 92 patients (25%), including 11 type 1a (T1aE), 3 type 1b, and 78 type 2 (T2E) endoleaks. On logistic regression analysis, neck diameter >30 mm (P = 0.032) and initial AAA sac diameter >55 mm (P = 0.031) were associated with T1aE. No association was found with T2E. Overall, 107 (27%) patients had sac expansion at 1 year associated with the presence of T2E (P = 0.019). No association was observed between T1aE or T2E and specific endograft. Conclusions Newer generation endografts show very satisfactory performance even in difficult anatomies. T1aE was associated with initial sac and neck diameter, while AAA sac expansion was associated with the presence of T2E. © 2016 Elsevier Inc.