Risk Factors, Dynamics, and Clinical Consequences of Aortic Neck Dilatation after Standard Endovascular Aneurysm Repair

• DOI: 10.1016/j.ejvs.2021.03.020
• Publication Date: 2021-06-02T13:15:18Z
• Authors: Nelson F.G. Oliveira; José Oliveira-Pinto; Marie J. van Rijn; Sara Baart; Sander Ten Raa; Sanne E. Hoeks; Frederico Bastos ...; Hence J.M. Verhagen
• Keywords: Interquartile range; Endovascular aneurysm repair

Aortic neck dilatation (AND) occurs after endovascular aneurysm repair (EVAR) with self expanding stent grafts (SESs). Whether it continues, ultimately exceeding the endograft diameter leading to abdominal aortic (AAA) rupture, remains uncertain. Dynamics, risk factors, and clinical relevance of AND were investigated EVAR standard SESs.All intact patients treated from 2000 2015 at a tertiary institution included. Demographic, anatomical, device related characteristics as factors for AND. Outer outer diameters measured single standardised level on reconstructed computed tomography (CT) images.A total 460 included (median follow up 5.2 years, interquartile range [IQR] 3.0, 7.7 years; CT imaging 3.3 IQR 1.3, 5.4). Baseline was 24 mm (IQR 22, 26) increased 11.1% 1.5%, 21.9%) last imaging. Endograft oversizing 20.0% 13.6, 28.0). greater during first year (5.2% [IQR 0, 11.7]) decreasing subsequently (two four years 1.4%/year 0.0, 4.5%], p ≤ .001) associated suprarenal fixation endografts (t value = 7.9, < 4.4, .001). 3.5% (95% CI 2.2% - 4.8%) 14.4% 11.0% 17.8%) five eight respectively. Excessive baseline (OR 1.2/mm, 95% 1.05 1.41) while Excluder had protective effect 0.15, 0.04 0.58). type 1A endoleak (HR 3.3, 1.1 9.7) migration > 5 3.1, 1.4 6.9).AND SES is radial force but decelerates post-operative year. bearing an beyond nominal graft diameter. However, unclear whether patient selection, differences in or are accountable this difference.