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

Toshihiro Onohara; Nobuhiro Handa; Masakazu Kawasaki; Fuminori Kasashima; Tetsuya Saito; Teruya Nakamura; Dai Une; Mikizo Nakai; Suguru Shiraya; Kazuki Maeda; Katsuhiko Imai; Tsuyoshi Yamamoto; Yasushi Shimoe; Minoru Okamoto; Yoshikazu Kawazu; on behalf of National Hospital Organization Network Study Group in Japan for Abdominal Aortic Aneurysm

doi:10.3400/avd.oa.23-00072

Original Article

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

Toshihiro Onohara , Nobuhiro Handa, Masakazu Kawasaki, Fuminori Kasashima, Tetsuya Saito, Teruya Nakamura, Dai Une, Mikizo Nakai, Suguru Shiraya, Kazuki Maeda, Katsuhiko Imai, Tsuyoshi Yamamoto, Yasushi Shimoe, Minoru Okamoto, Yoshikazu Kawazu, on behalf of National Hospital Organization Network Study Group in Japan for Abdominal Aortic Aneurysm

Author information

Toshihiro Onohara Corresponding author
Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Fukuoka, Japan
Nobuhiro Handa
Department of Cardiovascular Surgery, Nagara Medical Center, Gifu, Gifu, Japan
Masakazu Kawasaki
Department of Cardiovascular Surgery, Hokkaido Medical Center, Sapporo, Hokkaido, Japan
Fuminori Kasashima
Department of Cardiovascular Surgery, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
Tetsuya Saito
Department of Cardiovascular Surgery, Osaka National Hospital, Osaka, Osaka, Japan
Teruya Nakamura
Department of Cardiovascular Surgery, Osaka Minami Medical Center, Kawachinagano, Osaka, Japan
Dai Une
Department of Cardiovascular Surgery, Okayama Medical Center, Okayama, Okayama, Japan
Mikizo Nakai
Department of Cardiovascular Surgery, Okayama Medical Center, Okayama, Okayama, Japan
Suguru Shiraya
Department of Cardiovascular Surgery, Hamada Medical Center, Hamada, Shimane, Japan
Kazuki Maeda
Department of Cardiovascular Surgery, Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan
Katsuhiko Imai
Department of Cardiovascular Surgery, Kure Medical Center, Kure, Hiroshima, Japan
Tsuyoshi Yamamoto
Department of Cardiovascular Surgery, Iwakuni Medical Center, Iwakuni, Yamaguchi, Japan
Yasushi Shimoe
Department of Cardiovascular Surgery, Shikoku Medical Center for Children and Adults, Zentsūji, Kagawa, Japan
Minoru Okamoto
Department of Cardiovascular Surgery, Kumamoto Medical Center, Kumamoto, Kumamoto, Japan
Yoshikazu Kawazu
Department of Cardiovascular Surgery, Kagoshima Medical Center, Kagoshima, Kagoshima, Japan
on behalf of National Hospital Organization Network Study Group in Japan for Abdominal Aortic Aneurysm

Keywords: abdominal aortic aneurysm, endovascular aneurysm repair, open surgical repair, young patients

JOURNAL OPEN ACCESS

2024 Volume 17 Issue 1 Pages 25-33

DOI https://doi.org/10.3400/avd.oa.23-00072

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Details

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.

Corresponding author

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