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. 2024 Mar 25;17(1):25-33.
doi: 10.3400/avd.oa.23-00072. Epub 2024 Feb 6.

Long-Term Outcomes of Endovascular Aneurysm Repair in Patients Aged ≤70 Years

Toshihiro Onohara  1 , Nobuhiro Handa  2 , Masakazu Kawasaki  3 , Fuminori Kasashima  4 , Tetsuya Saito  5 , Teruya Nakamura  6 , Dai Une  7 , Mikizo Nakai  7 , Suguru Shiraya  8 , Kazuki Maeda  9 , Katsuhiko Imai  10 , Tsuyoshi Yamamoto  11 , Yasushi Shimoe  12 , Minoru Okamoto  13 , Yoshikazu Kawazu  14 ; National Hospital Organization Network Study Group in Japan for Abdominal Aortic Aneurysm
Affiliations

Long-Term Outcomes of Endovascular Aneurysm Repair in Patients Aged ≤70 Years

Toshihiro Onohara et al. Ann Vasc Dis. .

Abstract

Objectives: The efficacy of endovascular aneurysm repair (EVAR) against abdominal aortic aneurysm (AAA) in younger patients remains unknown. Hence, the current study aimed to investigate whether the aneurysm-related mortality rate of EVAR is acceptable among patients aged ≤70 years. Methods: Among 644 patients, 148 underwent EVAR (EVAR group), and 496 received open surgical repair (OSR group). The cumulative incidence rates of aneurysm-related death, any intervention, and serious aneurysm-related events after AAA repair were evaluated using the cumulative incidence function in the presence of competing risks. Results: The EVAR group had higher prevalences of several comorbidities, and overall survival for the EVAR group was significantly inferior to that of the OSR group. The cumulative incidence rates of aneurysm-related death, any intervention, and serious aneurysm-related events at 5 years were 1.5%, 11.7%, and 6.4% in the EVAR group and 1.3%, 5.3%, and 5.9% in the OSR group, respectively. EVAR was not a significant prognostic factor of aneurysm-related mortality and serious aneurysm-related events. However, it was an independent poor prognostic factor of any intervention. Conclusion: EVAR was not a significant prognostic factor of aneurysm-related mortality and serious aneurysm-related events. Therefore, it demonstrated acceptable procedure-related long-term outcomes, at least in high-risk young patients.

Keywords: abdominal aortic aneurysm; endovascular aneurysm repair; open surgical repair; young patients.

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Figures

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Fig. 1 Cumulative survival between the EVAR and OSR groups. The cumulative survival rates of the EVAR group were significantly lower than those of the OSR group. EVAR: endovascular aneurysm repair; OSR: open surgical repair; AAA: abdominal aortic aneurysm
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Fig. 2 Cumulative incidence of cause-specific mortality between the EVAR and OSR groups. Aneurysm-related mortality (A), cardiovascular-related mortality (B), cancer-related mortality (C), and infection-related mortality (D). The prevalence of infection-related mortality was significantly higher in the EVAR group than in the OSR group. No significant differences were found in terms of the cumulative incidence rates of aneurysm-, cardiovascular-, and cancer-related mortality between the two groups. EVAR: endovascular aneurysm repair; OSR: open surgical repair; AAA: abdominal aortic aneurysm
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Fig. 3 Cumulative incidence of any intervention (A) and serious aneurysm-related events (B) between the EVAR and OSR groups. The cumulative incidence rates of any intervention were significantly higher in the EVAR group than in the OSR group. However, the cumulative incidence rates of serious aneurysm-related events did not significantly differ between the two groups. EVAR: endovascular aneurysm repair; OSR: open surgical repair; AAA: abdominal aortic aneurysm
See this image and copyright information in PMC

References

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