Wien Klin Wochenschr. 2025 Dec 6. doi: 10.1007/s00508-025-02666-9. Online ahead of print.
ABSTRACT
OBJECTIVE: The aim of the study was to investigate the performance of endovascular aortic aneurysm repair (EVAR) with suprarenal fixation endografts in wide necks for intact abdominal aortic aneurysms (iAAA).
METHODS: Anatomical data of the treated iAAAs, acquired from a thin slice computed tomography angiography (CTA) of the abdomen with 3‑dimentional reconstructions preoperatively and postoperatively, were evaluated. A statistical analysis comparing the anatomical characteristics of the aneurysm neck according to the presence of an endoleak was conducted using the SPSS Statistics package version 29.
RESULTS: Between January 2020 and October 2024, 114 patients (105, 92.1% males, median age 75 years) with iAAAs underwent EVAR, most of them (83) with Endurant II/IIs stent-graft (Medtronic, Santa Rosa, US) and of them 15 had a wide neck (28 mm or more). In a multivariate logistic regression analysis the presence of a wide neck had a statistically significant association with the development of a type Ia endoleak (odds ratio, OR 12.961, p = 0.025). A type Ia endoleak was present in 2 of these patients in the first 30 postoperative days. In these 2 patients the oversizing percentage of the proximal landing zone was significantly lower compared to the patients with a wide neck without type Ia endoleak (median oversizing 11.3%, range 6.6-16% vs. 20%, range 15-25%, p = 0.019). The endoleak was persistent in a follow-up period of 18 months.
CONCLUSION: The use of EVAR with suprarenal fixation endografts in wide infrarenal necks is safe but in the case of poor oversizing, there is a significant risk for development of a persistent type Ia endoleak.
PMID:41351797 | DOI:10.1007/s00508-025-02666-9
