Clinical Outcome after Endovascular Sealing of Abdominal Aortic Aneurysms: A Retrospective Cohort Study

The aim of this study is to present the clinical outcome of endovascular aneurysm sealing (EVAS) with the Nellix endoprosthesis in patients with abdominal aortic aneurysms treated in our institution.

This is a retrospective, single center, observational cohort study. A departmental database was interrogated to extract demographics, clinical information, and outcome of all patients treated with EVAS between December 2013 and December 2015. Outcome measures included technical success (successful device deployment and absence of any endoleak at completion angiography), mortality, major complications, incidence of endoleaks, aneurysm rupture, and reintervention.

Sixty-five patients (49 men) with a mean (standard deviation) age of 78 (6.9) years were successfully treated with EVAS, with no 30-day mortality. The cohort included 1 patient with ruptured aneurysm, 9 patients with late complications of previous aortoiliac repairs (2 open, 7 endovascular), and 4 patients who required a total of 9 visceral chimneys for juxtarenal aneurysms. Six patients (9%) suffered major postoperative complications and 4 (6%) required intervention. There were no early or late endoleaks or aneurysm ruptures. After a median (range) follow-up of 12 (0-24) months, there was no aneurysm-related mortality; 2 patients (3%) required late aneurysm-related interventions.

EVAS can be performed with good outcomes up to 2 years postoperatively. Longer follow-up on larger cohorts is needed to prove the efficacy of this technique.