EVAR in Small Versus Large Aneurysms: Does Size Influence Outcome?

Abstract

Objective: To determine whether there is a difference in outcome between endovascular repair of abdominal aortic aneurysm (EVAR) of small versus large aneurysms. Methods: A total of 192 patients from the Power-link trial were subdivided into small abdominal aortic aneurysms (AAA; ≤5 cm) and large AAA (>5 cm) groups. Demographics, perioperative morbidity, mortality, overall survival, and freedom from major adverse events, endoleak, aneurysm-related death, migration, and secondary procedures were assessed. Aneurysmal involvement of the iliacs as well as neck length and angulation was compared between groups. Results: Perioperative morbidity (P = 1.000), mortality (P = .4603), and extent of iliac involvement did not differ between groups (P = .2260). The necks in small AAA were longer (P = .0028) and less angulated (P < .0001). There was no difference in overall survival (P = .6066), freedom from major adverse events (P = .7842), endoleak, (P = .1832), migration (P = .5765), aneurysm-related death (P = .4728), or need for secondary procedures (P = .2323). Conclusion: Under controlled conditions of patient and device selection, there is no significant difference in outcome for EVAR of small versus large AAA.

Keywords

AAA EVAR aneurysm

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