Abdominal aortic aneurysm size regression after endovascular repair is endograft dependent

Abstract

Objective: This study was performed to determine whether abdominal aortic aneurysm (AAA) regression is different with various endografts after endovascular repair. Methods: A four-center retrospective review of size change after endovascular AAA repair was performed. Consecutive patients with at least 1-year follow-up and available imaging studies were included. Three hundred ninety patients received either the Ancure, AneuRx, Excluder, or Talent endograft. AAA size and endoleak status were recorded from computed tomography (CT) scans at the initial postoperative follow-up visit and at 1 and 2 years thereafter. AAA size was defined as the minor axis of the infrarenal aorta on the largest axial section on the two-dimensional CT scan. A change in AAA size of 0.5 cm or greater from baseline was considered clinically significant. The effect of initial size, endoleak, and type of endograft on AAA regression was analyzed. Results: Mean baseline size was significantly greater with Talent endografts and smaller with Excluder endografts. Clinically significant regression in AAA size occurred in nearly three fourths of patients with Ancure and Talent endografts at 2 years. Regression in AAA size was less frequent with the AneuRx (46%) and Excluder (44%) devices. Initial size, endoleak, and endograft type were significant predictors of regression at multivariate analysis at 1 year. However, by 2 years only endograft type was still an independent predictor of AAA shrinkage. Conclusions: Long-term morphologic changes after endovascular aneurysm repair depend on endograft type.