[Immediate and long-term results of abdominal aortic arthroplasty for aneurysms]

The least invasive method of surgical treatment and prevention of rupture of abdominal aortic aneurysms is abdominal aortic arthroplasty (Endovascular Aneurysm Repair, EVAR). However, despite all the advantages, this minimally invasive endovascular intervention does not demonstrate superiority over open prosthetics in the long term due to the occurrence of postoperative complications. The aim of the study was to evaluate the immediate and long-term results of EVAR in order to form an algorithm for determining the volume of intervention that reduces the likelihood of postoperative complications.

From 2010 to 2025, 126 patients underwent EVAR in the departments of vascular surgery at the F.I. Inozemtsev State Clinical Hospital. The average age of the patients was 67.68±0.88 years. The average size of abdominal aortic aneurysms is 56.98±0.28 mm (median is 50 mm). Puncture access was used in 59.5% of patients, and open projection femoral access was used in 40.5%. The following endografts were identified: Endurant II - 60.32%, Ankura - 16.53%, Anaconda - 15.70%, Gore Excluder - 8.73%. The average duration of the operation was 136.43±0.37 (2 hours 16 minutes).

The average bed-day is 6.41±0.26. A total of 26 (20.64%) complications were registered. Of these, 8 (6.4%) were in the first 30 days after surgery, while the remaining 18 (14.3%) were in the long-term postoperative period. Long-term results were estimated on average 3-4 years after surgery. Endolics were found most often (7.1%) (type I - 4.8%, type II - 2.4%). As a result, the cumulative 5-year survival rate was 83%.

EVAR is a promising minimally invasive intervention for aneurysms of the infrarenal abdominal aorta, through which it is possible to reduce the risk of significantly reducing the number of complications in the early postoperative period, hospital mortality and hospital stay. Long-term results also demonstrate acceptable effectiveness of this method and a fairly low incidence of complications. All patients after EVAR should undergo annual screening in the amount of multi-spiral computed tomography.