47 - Young Investigator Meeting
Young Investigator Meeting
4. November 2022, 13:00 - 14:00, Gartensaal 2
Predictors and Consequences of Sac Shrinkage after Endovascular Infrarenal Aortic Aneurysm Repair
S. Vedani1, S. Petitprez1, E. Weinz1, J.-M. Corpataux1, S. Déglise1, C. Deslarzes-Dubuis1, E. Côté1, J.-B. Ricco2, F. Saucy3, Presenter: S. Vedani1 (1Lausanne, 2Poitiers, 3Morges)
Aneurysm shrinkage has been proposed as a marker of successful endovascular aneu-rysm repair (EVAR). We evaluated the impact of sac shrinkage on secondary interven-tions,survival and its association with endoleaks and compliance with instructions for use (IFU).
This observational retrospective study was conducted on all consecutive patients receiving EVAR for an infrarenal abdominal aortic aneurysm (AAA) using exclusively Endurant II/IIs endograft from 2014 to 2018. Sixty patients were entered in the study. Aneurysm sac shrinkage was defined as decreased ≥5 mm of the maximum aortic diameter. Univariate methods and Kaplan-Meier plots assessed the potential impact of shrinkage.
26 patients (43.3%) experienced shrinkage at one year, and 34 (56.7%) had no shrinkage. Shrinkage was not significantly associated with any demographics and morbidity except hypertension (p = .01). No aneurysm characteristics were associated with shrinkage. Non-compliance with instructions for use (IFU) in 13 patients (21.6%) was not associated with shrinkage. Three years after EVAR, freedom from secondary intervention was 85±2 % for the entire series, 92.3±5.0% for the shrinkage group and 83.3±9% for the no-shrinkage group (Logrank: p=.49). Survival at three years was not significantly dif-ferent between the two groups (85.9±7.0% vs 79.0±9.0%, Logrank; p=.59). Strict com-pliance with IFU was associated with less reinterventions at three-year (92.1±5.9% vs 73.8±15%, Logrank: p=.03). Similarly, survival at three years did not significantly differ between strict compliance to IFU and non compliance (81.8±7.0% vs 78.6±13.0%, Logrank; p=.32).
This study suggests that shrinkage ≥5 mm at 1-year is not significantly associated with a better survival or a lower risk of secondary intervention than no-shrinkage. In this series, the risk of secondary intervention regardless of shrinkage seems to be linked more to non-compliance with IFU. Considering the small number of patients, these results must be confirmed by extensive prospective studies.