Predictors and Consequences of Sac Shrinkage after Endovascular Infrarenal Aneurysm Repair

Introduction: Aneurysm shrinkage has been proposed as a marker of successful endovascular aneurysm repair (EVAR). We evaluated the impact of sac shrinkage on secondary interventions and survival and its association with endoleaks and compliance with instructions for use (IFU).

Method(s): This observational retrospective study was conducted at the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland, on all consecutive patients receiving EVAR for an infrarenal abdominal aortic aneurysm (AAA) using exclusively Endurant II/IIs endograft from 2014 to 2018. Sixty patients with ≥1-year computed tomography angiography follow-ups were entered in the study. Aneurysm sac shrinkage was defined as decreased ≥5 mm of the maximum aortic diameter.

Result(s): A total of 26 patients (43.3%) experienced shrinkage at 1 year, and 34 (56.7%) had no shrinkage. Shrinkage was not significantly associated with any demographics and morbidity except hypertension. Strict compliance with IFU was associated with higher rate of freedom from secondary intervention at 3 years.

Conclusion(s): This study suggests that shrinkage ≥5 mm at 1 year is frequent but not significantly associated with a better survival or a lower risk of secondary intervention than no shrinkage.

Publication History

Article published online:
09 February 2023