EVAR in small versus large aneurysms: does size influence outcome?

Vasc Endovascular Surg. 2009 Jun-Jul;43(3):244-51. doi: 10.1177/1538574408327570. Epub 2008 Dec 16.

Abstract

Objective: To determine whether there is a difference in outcome between endovascular repair of abdominal aortic aneurysm (EVAR) of small versus large aneurysms.

Methods: A total of 192 patients from the Power-link trial were subdivided into small abdominal aortic aneurysms (AAA; </=5 cm) and large AAA (>5 cm) groups. Demographics, perioperative morbidity, mortality, overall survival, and freedom from major adverse events, endoleak, aneurysm-related death, migration, and secondary procedures were assessed. Aneurysmal involvement of the iliacs as well as neck length and angulation was compared between groups.

Results: Perioperative morbidity (P = 1.000), mortality (P = .4603), and extent of iliac involvement did not differ between groups (P = .2260). The necks in small AAA were longer (P = .0028) and less angulated (P < .0001). There was no difference in overall survival (P = .6066), freedom from major adverse events (P = .7842), endoleak, (P = .1832), migration (P = .5765), aneurysm-related death (P = .4728), or need for secondary procedures (P = .2323).

Conclusion: Under controlled conditions of patient and device selection, there is no significant difference in outcome for EVAR of small versus large AAA.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / pathology
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Blood Vessel Prosthesis Implantation* / mortality
  • Female
  • Foreign-Body Migration / etiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Treatment Outcome