Long-term outcomes of endovascular aortic repair with flared iliac limb endografts in patients with abdominal aortic aneurysm and aneurysmal common iliac arteries.
J Cardiovasc Surg (Torino)
; 63(4): 464-470, 2022 Aug.
Article
de En
| MEDLINE
| ID: mdl-35238520
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate the long-term outcomes of endovascular aneurysm repair with flared iliac limb grafts in patients with abdominal aortic aneurysm (AAA) and aneurysmal common iliac arteries (CIAs).METHODS:
This is a multicenter, retrospective, observational cohort study that involves four tertiary referral hospitals between May 1, 2005, and April 30, 2019. Primary outcomes were freedom from aneurysm-related mortality (ARM), and freedom from iliac-related reintervention.RESULTS:
We studied 995 aneurysmal iliac limbs in 795 (85.2%) patients who met the inclusion criteria. Median AAA diameter was 55mm (IQR 51-60). Early mortality occurred in 3 (0.4%) patients. The median of follow-up time was 52 months (IQR 26-88). Estimated freedom from ARM was 99±0.002% (95% CI 99-99.9) at 1 year, and 99±0.004% (95% CI 97.9-99.6) at 5-years. Chronic obstructive pulmonary disease (HR=6.4, 95% CI 1.7-24.0, P=0.006), chronic kidney disease (HR=5.5, 95% CI 1.4-21.9, P=0.016), and the presence of an aneurysmal left CIA (HR=5.3, 95% CI 1.0.5-27.4, P=0.044) was associated with ARM. There were 42 (7.3%) late iliac-related events (limb occlusion, N.=5; iliac-related endoleaks, N.=37). Estimated freedom from iliac-related reintervention was 98±0.003% (95% CI 97-99) at 1 year, and 95±0.01% (95% CI 92.7-96.7) at 5-years, which was associated with an aneurysmal right CIA (HR=2.2, 95% CI 1.3-3.9; P=0.005), and age ≥78 years (HR=1.9, 95% CI 1.01-1.3; P=0.039).CONCLUSIONS:
EVAR flared iliac limb grafts showed a high rate of freedom from ARM and a low reintervention rate. Owing to these results, it can be a durable and stable alternative for patients aged >78 years.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Anévrysme de l'aorte abdominale
/
Implantation de prothèses vasculaires
/
Procédures endovasculaires
Type d'étude:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limites:
Humans
Langue:
En
Journal:
J Cardiovasc Surg (Torino)
Année:
2022
Type de document:
Article
Pays d'affiliation:
Italie