Late Sac Behavior after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm

Masahiro Okada; Nobuhiro Handa; Toshihiro Onohara; Minoru Okamoto; Tsuyoshi Yamamoto; Yasushi Shimoe; Masafumi Yamashita; Toshiki Takahashi; Jyunji Kishimoto; Akihiro Mizuno; Junichi Kei; Mikizou Nakai; Masayuki Sakaki; Hitoshi Suhara; Fuminori Kasashima; Masamitsu Endo; Takeshi Nishina; Tadashi Furuyama; Masakazu Kawasaki; Keiji Iwata; Akira Marumoto; Yasuhisa Urata; Katsutoshi Sato; Masahiro Ryugo; National Hospital Organization Network Study Group for Abdominal Aortic Aneurysm in Japan

doi:10.3400/avd.oa.15-00125

Original Articles

Late Sac Behavior after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm

Masahiro Okada, Nobuhiro Handa, Toshihiro Onohara, Minoru Okamoto, Tsuyoshi Yamamoto, Yasushi Shimoe, Masafumi Yamashita, Toshiki Takahashi, Jyunji Kishimoto, Akihiro Mizuno, Junichi Kei, Mikizou Nakai, Masayuki Sakaki, Hitoshi Suhara, Fuminori Kasashima, Masamitsu Endo, Takeshi Nishina, Tadashi Furuyama, Masakazu Kawasaki, Keiji Iwata, Akira Marumoto, Yasuhisa Urata, Katsutoshi Sato, Masahiro Ryugo, National Hospital Organization Network Study Group for Abdominal Aortic Aneurysm in Japan

Author information

Masahiro Okada
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Nobuhiro Handa
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Toshihiro Onohara
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Minoru Okamoto
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Tsuyoshi Yamamoto
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Yasushi Shimoe
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Masafumi Yamashita
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Toshiki Takahashi
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Jyunji Kishimoto
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Akihiro Mizuno
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Junichi Kei
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Mikizou Nakai
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Masayuki Sakaki
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Hitoshi Suhara
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Fuminori Kasashima
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Masamitsu Endo
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Takeshi Nishina
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Tadashi Furuyama
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Masakazu Kawasaki
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Keiji Iwata
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Akira Marumoto
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Yasuhisa Urata
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Katsutoshi Sato
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
Masahiro Ryugo
Office of Medical Devices, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
National Hospital Organization Network Study Group for Abdominal Aortic Aneurysm in Japan

Keywords: abdominal aortic aneurysm, endovascular aneurysm repair, sac behavior, endoleak, late rupture

JOURNAL FREE ACCESS

2016 Volume 9 Issue 2 Pages 102-107

DOI https://doi.org/10.3400/avd.oa.15-00125

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Details

Abstract

Background: Sac behavior after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is considered as a surrogate for the risk of late rupture. The purpose of the study is to assess the sac behavior of AAAs after EVAR.Methods and Results: Late sac enlargement (LSE) (≥5 mm) and late sac shrinkage (LSS) (≥5 mm) were analyzed in 589 consecutive patients who were registered at 14 national centers in Japan. The proportions of patients who had LSE at 1, 3 and 5 years were 2.6% ± 0.7%, 10.0% ± 1.6% and 19.0% ± 2.9%. The proportions of patients who had LSS at 1, 3 and 5 years were 50.1% ± 0.7%, 59.2% ± 2.3% and 61.7% ± 2.7%. Multiple logistic regression analysis identified two variables as a risk factor for LSE; persistent endoleak (Odds ratio 9.56 (4.84–19.49), P <0.001) and low platelet count (Odds ratio 0.92 (0.86–0.99), P = 0.0224). The leading cause of endoleak in patients with LSE was type II.Conclusions: The incidence of LSE is not negligible over 5 year period. Patients with persistent endoleak and/or low platelet count should carefully be observed for LSE.Clinical Trial Registration: UMIN-CTR (UMIN000008345).

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