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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Italian Journal of Vascular and Endovascular Surgery 2010 December;17(4):259-64
Middle versus long-term results in EVAR: a ten-year follow-up experience
Nano G., Mazzaccaro D., Tealdi D. G.
First Unit of Vascular Surgery, IRCCS Policlinico San Donato, University of Milan. Milan, Italy
Aim. Endovascular repair of abdominal aortic aneurysms is a relatively new technique, with few studies about long-term results. Our aim was to find if endovascular aneurysm repair (EVAR)’s complication rates at long-term were higher than at middle-term and to define a minimal period of follow-up to consider a patient as completely recovered.
Methods. From 1998 to 2003, 186 patients underwent EVAR in our center. Patients were followed-up at 1, 6, 12 months and every year. Mean follow-up period was 89 months for long-term result (range 61-121 months). We collected data about cardiac and renal complications, thrombosis, surgical conversions, endoleaks, death and death from aortic rupture. All data were analysed using Sigma Statâ 3.0.
Results. We observed a significant increase of mortality rate (50.40% vs. 33.70%, P<0.05); we recorded an increase in the incidence of cardiovascular adverse events (5.80% vs. 1.80%), thrombosis of EVG (2.90% vs. 1.90%), type II (3.90% vs. 3.20%) and type III endoleaks (0.89% vs. 0.53%), but there were not any statistical significant differences. Incidence of renal failure and type I endoleak were significant lower than at middle-term. There weren’t any type IV endoleaks or surgical conversion after 60 months.
At 120 months 24.58% of patients were alive and free from any major adverse events and 96,87% were free from aortic rupture.
Conclusion. EVAR had important complications at long-term follow-up, but their rates weren’t significantly higher than those of middle-term; the incidence of late aortic rupture was acceptably low. We could not define a period of follow-up after which a patient could be considered as completely recovered.