Objective. To assess the efficacy and safety of endovascular treatment for infrarenal abdominal aortic aneurysms depending on their size. Material and methods. This retrospective study included 214 patients who underwent endovascular repair of infrarenal aortic aneurysms between 2017 and 2023. Patients were divided into two groups depending on maximum aneurysm diameter: group 1 (n=147) — < 70 mm; group 2 (n=67) — ≥70 mm. We analyzed intraoperative, hospital, and long-term outcomes. Results. Intraoperative and in-hospital outcomes were comparable, except for longer procedure and fluoroscopy times in patients with large aneurysms. In long-term period, patients with aneurysms ≥70 mm had significantly higher incidence of type IB endoleaks (p=0.04), branch stent graft thrombosis (p=0.04), and aneurysm sac growth (p<0.001). Conclusion. Endovascular repair of infrarenal abdominal aortic aneurysms is a highly effective and safe method regardless of aneurysm size. However, patients with aneurysms ≥70 mm exhibit higher rate of long-term complications. Optimization of stent graft fixation techniques and development of long-term follow-up protocols will minimize the risk of adverse outcomes.
Polyakov et al. (Thu,) studied this question.