Comparative study of clinical outcome of endovascular aortic aneurysms repair in large diameter aortic necks (31?mm) versus smaller necks

摘要

BackgroundThis study compares short-term (30?days) and intermediate term (3?years) clinical outcomes in patients with large (≥31?mm) versus small aortic neck diameters (≤28 and ≤31?mm). MethodsProspectively collected data from 741 patients who underwent endovascular aortic aneurysm repair were analyzed. Some surgeons have reported the threshold for a large aortic neck for endovascular aortic aneurysm repair to be 28?mm, whereas for others it is 31?mm. Therefore, we classified aortic neck diameter into less than or equal to 28 versus greater than 28?mm; and less than or equal to 31 versus greater than 31?mm. Logistic regression and Kaplan-Meier analyses were used to compare outcomes. ResultsThere were 688 patients who had a defined aortic neck diameter: 592 with less than or equal to 28?mm, 96 with greater than 28?mm, 655 with less than or equal to 31?mm, and 33 with greater than 31?mm. The mean follow-up was 25.2?months for less than or equal to 31?mm versus 31.8?months for greater than 31?mm. Clinical characteristics were similar in all groups, except that there were more patients outside the instructions for use in the greater than 31?mm versus less than or equal to 31?mm group (94% vs 44%;P? 31?mm) had higher rates of early and late type I endoleak, sac?expansion, late intervention, and mortality.