Fifteen Year Outcome Results of Endovascular Aortic Repair with a Third Generation Endograft

Long term patient and re-intervention free survival outcomes after aortic endografting are scarce. In this study, long term outcomes of patients initially presenting with an aortic or aorto-iliac aneurysm and treated with the Zenith endograft were assessed.

This single centre, retrospective, observational study examined overall survival (OS), re-intervention free survival, and occurrence of adverse events during follow up of patients treated with Zenith endografts. Data of 209 patients who underwent endovascular aneurysm repair with the Zenith Endoprosthesis between January 1998 and December 2009 in an academic, tertiary care centre for aortic disease were analysed. Follow ups were analysed until January 2024 to ensure a follow up time of at least 14 years. The primary end points were OS and re-intervention free survival. Secondary end points were endograft related complications, endoleaks, and re-interventions.

OS at two, five, ten, and 15 year follow up was 89%, 71%, 40%, and 18%, respectively. Re-intervention free survival was 83%, 76%, 69%, and 66% at two, five, ten, and 15 year follow up, respectively; 87 re-interventions in 60 patients were performed in the zero to eight year follow up period. After ten years or more of follow up, there were 15 re-interventions performed in ten patients. Freedom from type I and III endoleaks at five and 15 years were 93% and 86%, respectively. The vast majority of type I (n = 29 of 37) and type III endoleaks (n = 3 of 4) occurred in the first eight years of post-operative follow up.

Endovascular aneurysm repair using the Zenith Endoprosthesis is effective and durable on long term follow up, with acceptably low endograft related complications and re-interventions. The number of re-interventions for type I and III endoleaks is low after eight years of follow up.