Results
A total of 222 patients underwent EVAR procedure at 7 years period and
the procedures were carried out by the same team of cardiovascular
surgeons. Baseline characteristics of the patients are summarized in
Table 1. The median age of the patients was 70 years (range, 46 to 92
years) and study population was predominantly male (202 patients, 91%).
The median stay in the intensive care unit and in the hospital were 4
hours (range, 2 to 240 hours) and 2 days (range, 1 to 20 days)
respectively. Perioperative features are reviewed at Table 2.
In hospital mortality was 1.8% (four patients of 222). Follow-up was
available in all 218 survivors. Excluding four in-hospital mortalities,
routine follow-up of remainders was included in the outcome assessment.
The median follow-up period was 20 months (range, 1 to 80 months). The
follow-up data are shown in Table 3.
Five-year freedom from any endoleak was 65% with a 95% confidence
interval (CI) of 54.3-74.9%. On the other hand, freedom from type 1a
endoleaks, type 1b endoleaks, type 2 endoleaks and type 3 endoleaks was
97.5% (95% CI: 95.1-99.9%), 92.5% (95% CI: 85.2-99.8%), 83.9%
(95% CI: 74.1-93.7%) and 86.5% (95% CI: 75.5-97.5%), respectively.
There were 36 late deaths (16.5%). Kaplan-Meier survival analysis
revealed that overall survival at one, three and five-years were 93%,
81% and 62% respectively (Figure 1). Freedom from secondary
intervention were 96%, 89% and 82% respectively for one, three and
five years (Figure 2). Indications for secondary intervention
(endovascular or open) were type III endoleak (6 patients), stent-graft
limb thrombosis (4 patients), type Ib endoleak (4 patients), type Ia
endoleak (3 patients), vascular access problems (2 patients) (Table 3)
Aneurysm sac diameter tend to be decreased after the procedure regarding
to the preoperative measurements (from median 60 mm to 58 mm, p=0.047).
At the follow-up period, 86% aneurysms were detected to be decreased in
size or remained stable, when considering that an increase 5 mm of
diameter as an enlargement.