Annals of vascular diseases · 2016
Late Sac Behavior after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm.
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Okada Masahiro, Handa Nobuhiro, Onohara Toshihiro, Okamoto Minoru, Yamamoto Tsuyoshi, Shimoe Yasushi, Yamashita Masafumi, Takahashi Toshiki, Kishimoto Jyunji, Mizuno Akihiro, Kei Junichi, Nakai Mikizou, Sakaki Masayuki, Suhara Hitoshi, Kasashima Fuminori, Endo Masamitsu, Nishina Takeshi, Furuyama Tadashi, Kawasaki Masakazu, Iwata Keiji, Marumoto Akira, Urata Yasuhisa, Sato Katsutoshi, Ryugo Masahiro, National Hospital Organization Network Study Group for Abdominal Aortic Aneurysm in Japan
Аннотация
BACKGROUND: Sac behavior after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is considered as a surrogate for the risk of late rupture. The purpose of the study is to assess the sac behavior of AAAs after EVAR.
METHODS AND RESULTS: Late sac enlargement (LSE) (≥5 mm) and late sac shrinkage (LSS) (≥5 mm) were analyzed in 589 consecutive patients who were registered at 14 national centers in Japan. The proportions of patients who had LSE at 1, 3 and 5 years were 2.6% ± 0.7%, 10.0% ± 1.6% and 19.0% ± 2.9%. The proportions of patients who had LSS at 1, 3 and 5 years were 50.1% ± 0.7%, 59.2% ± 2.3% and 61.7% ± 2.7%. Multiple logistic regression analysis identified two variables as a risk factor for LSE; persistent endoleak (Odds ratio 9.56 (4.84-19.49), P <0.001) and low platelet count (Odds ratio 0.92 (0.86-0.99), P = 0.0224). The leading cause of endoleak in patients with LSE was type II.
CONCLUSIONS: The incidence of LSE is not negligible over 5 year period. Patients with persistent endoleak and/or low platelet count should carefully be observed for LSE.
CLINICAL TRIAL REGISTRATION: UMIN-CTR (UMIN000008345).
METHODS AND RESULTS: Late sac enlargement (LSE) (≥5 mm) and late sac shrinkage (LSS) (≥5 mm) were analyzed in 589 consecutive patients who were registered at 14 national centers in Japan. The proportions of patients who had LSE at 1, 3 and 5 years were 2.6% ± 0.7%, 10.0% ± 1.6% and 19.0% ± 2.9%. The proportions of patients who had LSS at 1, 3 and 5 years were 50.1% ± 0.7%, 59.2% ± 2.3% and 61.7% ± 2.7%. Multiple logistic regression analysis identified two variables as a risk factor for LSE; persistent endoleak (Odds ratio 9.56 (4.84-19.49), P <0.001) and low platelet count (Odds ratio 0.92 (0.86-0.99), P = 0.0224). The leading cause of endoleak in patients with LSE was type II.
CONCLUSIONS: The incidence of LSE is not negligible over 5 year period. Patients with persistent endoleak and/or low platelet count should carefully be observed for LSE.
CLINICAL TRIAL REGISTRATION: UMIN-CTR (UMIN000008345).