Infrarenal Abdominal Aortic Aneurysms Endovascular Treatment: Long-Term Results Form A Single Center Experience In An Unselected Patients Population

Abstract Background Aim of present study was to evaluate early-, mid-, and long-term outcome in an unselected population of patients treated for abdominal aortic aneurysms (AAAs) by endovascular aneurysm repair (EVAR) with different commercially available off-the-shelf devices. Material and Methods A retrospective study was conducted on a prospectively compiled computerized database on patients presenting an infrarenal AAA treated between January 2008 and December 2015 in a high-volume Italian tertiary referral Centre. Demographic, clinical, and specific morphological features were considered as potentially influencing the outcome, as well as the type of implanted device. Outcomes measures were procedure-related reintervention, AAA-related, and all-cause mortality rates at 30-day, 12-month, and long-term follow-up. Reinterventions considered for the analysis were AAA rupture, graft infection, type I or III endoleaks, type II endoleaks with sac enlargement > 5mm, graft stenosis or occlusions, procedures related to renal or visceral ischemia, and reintervention for access vessel injury. Results Out of 498 EVAR procedures performed for elective infrarenal AAA treatment during the entire study period, 479 patients were enrolled, mean age was 73.5±7.34 years (range 51-91), and 416 (86.84%) were male. Mean maximum AAA diameter was 52.02±8.04mm (range 39-90.2), a maximum AAA diameter ≥59mm was recorded in 107 patients (22.33%), and an aortic neck length At univariate analysis, hypertension was the only demographical variable found to be associated with higher risk of reintervention, p=0.04 (OR:2.34; CI95%:1.00-5.42). Furthermore, male sex (p=0.02; OR:2.62; CI95%:1.09-6.27) and chronic renal insufficiency (p=0.003; OR:2.08; CI95%:1.27-3.42) were associated with higher mortality rates. AAA diameter ≥59mm was statistically associated with higher rate of both, reintervention and mortality: p Conclusions Our experience seems to suggest that EVAR could safely and effectively performed in an unselected patients’ population, with encouraging results up to ten-year follow-up.