Risk factors for proximal neck complications after endovascular aneurysm repair using the endurant stentgraft

F. Bastos Goncalves*, S. E. Hoeks, J. A. Teijink, F. L. Moll, J. A. Castro, R. J. Stolker, T. L. Forbes, H. J M Verhagen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)

Abstract

Objective To assess the incidence and risk factors for proximal aneurysm neck related complications with a late generation device for endovascular abdominal aneurysm repair (EVAR). Methods Data were retrieved from a prospective registry (Endurant Stent Graft Natural Selection Global Postmarket Registry) involving 79 institutions worldwide. The risk factors tested were age, gender, surgical risk profile, proximal neck length (30 mm), supra- and infrarenal angulation (>60° and 75°), mural thrombus/calcification (>50%) and taper (>10%), and AAA diameter (>65 mm). Two neck related composite endpoints were used, for intra-operative (type-1a endoleak, conversion, deployment/retrieval complication or unintentional renal coverage) and post-operative (type-1a endoleak or migration) adverse events. Independent risk factors were identified using multivariable backwards modeling. Results The study included 1263 patients (mean age 73, 10.3% female) from March 2009 to May 2011. Twenty three (1.8%) intra-operative adverse events occurred. Neck length 50% (OR 4.8, 95% CI 1.7-13.5) were risk factors for intra-operative events. The planned 1 year follow up visit was reached for the entire cohort, and the 2 year visit for 431 patients. During this time, 99 (7.8%) events occurred. Female gender (HR 1.9, 95% CI 1.1-3.2), aneurysm diameter >65 mm (HR 2.8, 95% CI 1.9-4.2), and neck length

Original languageEnglish
Pages (from-to)156-162
Number of pages7
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume49
Issue number2
DOIs
Publication statusPublished - 1 Feb 2015

Keywords

  • Abdominal
  • Aneurysm neck
  • Aortic aneurysm
  • Endovascular
  • Outcome
  • Risk factors
  • Surgical complications

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