SINGLE CENTER EXPERIENCE WITH EXCLUDER STENT GRAFT; 17 YEAR OUTCOME

Abstract

Background: EVAR has become a mainstay of abdominal aorta aneurysms treatment. Long term follow-up on specific stent grafts are needed.

Methods: In this study 123 patients (104 men; mean age 73,0 years, range 51 - 89) with abdominal aorta aneurysm, treated with Excluder stent graft between October 2002 and June 2008 were included. Periprocedural and follow-up data were retrieved by reviewing our Institution`s records, while time and cause of death was retrieved from National Institute of Health. If abdominal aortic aneurysm rupture was listed as a cause of death, records were retrieved from the institution where death certificate was issued. Our primary outcome was to assess primary technical success rate, type 1 and type 2 endoleak, reintervention-free survival, 30-days mortality, overall survival and aneurysm-rupture free survival.

Results: The median follow-up was 9,7 years (interquartile range, 4,6 to 13,8). Primary technical success was 98,4 % and 30-day mortality was 0,8 %. Secondary procedures were performed in 29 (23,6 %) patients during the follow-up period. One, 5, 10, 15 and 17- years overall survival was 94,3 %, 74,0 %, 47,2 %, 35,8 % and 35,8 %, while aneurysm-related survival was 98,4 %, 96,3 %, 92,6 %, 92,6 %, 92,6 %. In 7 (5,7 %) patients abdominal aortic rupture was assigned as the primary cause of death during follow-up.

Conclusion: Our data showed that EVAR with Excluder offers good long-term results. More than 75% of patients can be treated completely percutaneous. Late ruptures do occur in the first ten years, raising awareness about regular medical controls.