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Updated: Jun 28, 2026
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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Aneurysm rupture after EVAR: can the ultimate failure be predicted?
F J V Schlösser1, R J Gusberg, A Dardik
1Section of Vascular Surgery, Yale University, New Haven, CT 06510, United States.
Summary
AAA rupture after EVAR is often caused by endoleaks or graft migration within 2-3 years. Enhanced surveillance and improved stent-graft durability are key to reducing rupture risk.
Area of Science:
- Vascular Surgery
- Endovascular Aneurysm Repair (EVAR)
- Abdominal Aortic Aneurysm (AAA)
Background:
- Endovascular Aneurysm Repair (EVAR) is a common treatment for Abdominal Aortic Aneurysms (AAA).
- However, AAA rupture can still occur after EVAR, necessitating an understanding of its causes and timing.
Purpose of the Study:
- To investigate the primary causes and temporal patterns of AAA rupture following EVAR.
- To identify risk factors associated with AAA rupture post-EVAR.
Main Methods:
- Systematic review and data extraction from MEDLINE and EMBASE databases for AAA ruptures post-EVAR.
- Analysis of patient and procedural characteristics in identified cases.
Main Results:
- 270 AAA ruptures post-EVAR were identified, with endoleaks (160 cases) and graft migration (41 cases) as primary causes.
- Most ruptures occurred within 2-3 years post-EVAR, often in patients with large initial AAA diameters (mean 65 mm).
- Structural graft failure occurred in 96 patients, and 119 experienced a fatal outcome.
Conclusions:
- Intensified surveillance in the first 2-3 years post-EVAR may lower rupture rates, particularly for high-risk patients.
- Improved stent-graft durability and longevity are crucial for reducing AAA rupture risk.
- Complete prevention remains challenging as ruptures can occur without identifiable predisposing factors.
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