Effect of Preoperative Aneurysm Diameter on Long-Term Survival After Endovascular Aortic Aneurysm Repair

Abstract

Objective: To investigate the effect of aneurysm size on long-term survival after endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs). Methods: Retrospective study of all consecutive patients treated with EVAR for AAA at a single institution. Results: One hundred and nineteen patients (mean age 71, range 45-91) underwent EVAR during a 4-year period. The mean maximal aneurysm diameter was 58 mm (range 34-93 mm). Mean follow-up was 34 months (range 1-80). Cox regression analysis after controlling for age, renal function, coronary disease, and smoking showed a 4.9-fold higher risk of death for patients with preoperative aneurysm size ≥60 mm as compared to patients with aneurysm size <60 mm. No aneurysm-related deaths occurred during the follow-up. Conclusion: This present study provides evidence that aneurysm size ≥60 mm is independently associated with worse survival during follow-up.

Keywords

abdominal aortic aneurysm EVAR Zenith aneurysm size

Get full access to this article

View all access options for this article.

References

Schermerhorn

O'Malley

Jhaveri

Cotterill

Pomposelli

Landon

. Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med. 2008;358(5):464–474.

Greenhalgh

Brown

Powell

Thompson

Epstein

Sculpher

. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med. 2010;362(20):1863–1871.

Donas

Torsello

. Complications and reinterventions after EVAR: are they decreasing in incidence? J Cardiovasc Surg (Torino). 2011;52(2):189–192.

Mani

Bjorck

Lundkvist

Wanhainen

. Improved long-term survival after abdominal aortic aneurysm repair. Circulation. 2009;120(3):201–211.

de Virgilio

Tran

Lewis

. Factors affecting long-term mortality after endovascular repair of abdominal aortic aneurysms. Arch Surg. 2006;141(9):905–909; discussion 909-910.

Kertai

Boersma

Westerhout

. Association between long-term statin use and mortality after successful abdominal aortic aneurysm surgery. Am J Med. 2004;116(2):96–103.

Leurs

Visser

Laheij

Buth

Harris

Blankensteijn

. Statin use is associated with reduced all-cause mortality after endovascular abdominal aortic aneurysm repair. Vascular. 2006;14(1):1–8.

Chung

Corriere

Veeraswamy

. Risk factors for late mortality after endovascular repair of the thoracic aorta. J Vasc Surg. 2010;52(3):549–554; discussion 555.

Ohrlander

Dencker

Dias

Gottsater

Acosta

. Cardiovascular predictors for long-term mortality after EVAR for AAA. Vasc Med. 2011;16(6):422–427.

10.

Wisniowski

Barnes

Jenkins

Boyne

Kruger

Walker

. Predictors of outcome after elective endovascular abdominal aortic aneurysm repair and external validation of a risk prediction model. J Vasc Surg. 2011;54(3):644–653.

11.

Matsumura

Katzen

Sullivan

Dake

Naftel

. Predictors of survival following open and endovascular repair of abdominal aortic aneurysms. Ann Vasc Surg. 2009;23(2):153–158.

12.

Harris

Buth

Mialhe

Myhre

Norgren

The need for clinical trials of endovascular abdominal aortic aneurysm stent-graft repair: The EUROSTAR Project. EUROpean collaborators on Stent-graft Techniques for abdominal aortic Aneurysm Repair. J Endovasc Surg. 1997;4(1):72–77; discussion 78-79.

13.

Greenberg

Chuter

Sternbergh

3rd Fearnot

. Zenith AAA endovascular graft: intermediate-term results of the US multicenter trial. J Vasc Surg. 2004;39(6):1209–1218.

14.

D'elia

Tyrrell

Azzaoui

. Zenith (R) abdominal aortic aneurysm endovascular graft: a literature review. J Cardiovasc Surg (Torino). 2009;50(2):165–170.

15.

Peppelenbosch

Buth

Harris

van Marrewijk

Fransen

. Diameter of abdominal aortic aneurysm and outcome of endovascular aneurysm repair: does size matter? A report from EUROSTAR. J Vasc Surg. 2004;39(2):288–297.

16.

Beck

Goodney

Nolan

Likosky

Eldrup-Jorgensen

Cronenwett

JL.

Predicting 1-year mortality after elective abdominal aortic aneurysm repair. J Vasc Surg. 2009;49(4):838–843; discussion 843-844.