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Which Aneurysm Characteristics Predict EVAR Nonsuccess.

Pedro Pinto Sousa1, Pedro Brandão1, Alexandra Canedo1

  • 1Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal.

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Summary
This summary is machine-generated.

Anatomical factors like aneurysm angulation and diameter significantly influence endoleak development after endovascular abdominal aortic aneurysm repair (EVAR). Careful patient selection and consideration of surgical repair for unfavorable anatomy are crucial for successful outcomes.

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Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Aortic Aneurysm Disease

Background:

  • Hostile anatomy in endovascular abdominal aortic aneurysm repair (EVAR) can lead to complications.
  • Analyzing anatomical characteristics and endograft placement is key to understanding EVAR success.

Purpose of the Study:

  • To analyze anatomical factors in abdominal aortic aneurysms.
  • To correlate these factors with endoleak development and survival after EVAR.

Main Methods:

  • Retrospective review of elective EVAR procedures (2010-2016).
  • Analysis of preoperative CT scans for anatomical parameters.
  • Assessment of endoleak development and patient mortality as outcomes.

Main Results:

  • Aneurysm angulation, patent inferior mesenteric/lumbar arteries, and aneurysm diameter were associated with endoleak development (p<0.05).
  • 40% of aneurysms with significant axis deviation developed endoleak.
  • Patent inferior mesenteric/lumbar arteries were linked to early death post-EVAR (p=0.042).

Conclusions:

  • Unfavorable aneurysm morphology necessitates careful consideration, potentially favoring surgical repair.
  • Current follow-up protocols (angioCT at 1 and 12 months) are appropriate as most endoleaks occur within the first year.
  • Color duplex ultrasonography is a viable alternative for annual surveillance after the first year if no complications are noted.