Key result
Long-term anticoagulation after EVAR is not associated with better survival or fewer endoleaks.
Why the study?
Does anticoagulation affect the incidence of endoleaks or survival in patients after endovascular abdominal aortic aneurysm repair?
Cohort (n=192)
No
Does anticoagulation affect the incidence of endoleaks or survival in patients after endovascular abdominal aortic aneurysm repair?
Absolute Event Rate: 96.4% vs 95.6%
p-value: p=0.88
Long-term anticoagulation after EVAR appears safe and does not significantly increase the risk of endoleaks, reinterventions, or mortality.
Anticoagulation post-EVAR shows no adverse signal in cohort data; leaves open need for randomized confirmation before practice change.
Objective. A retrospective analysis of own experience of anticoagulation after endovascular abdominal aortic aneurysm repair (EVAR). Material and methods. We analyzed clinical data of 192 patients operated on between January 2017 and December 2020. The anticoagulation group included 30 patients, whereas 162 patients comprised the control group. Results. Mean follow-up period was 50.9±0.7 months. Survival rate was 96.4 and 95.6%, respectively (p=0.88). Intraoperative incidence of any type of endoleak was similar (0 and 3.1%, p=0.73), after 30 days — 13.3 and 10.5% (p=0.65), after a year — 0 and 1.9% (p=0.96), respectively. Reintervention rates were 6.7 (n=2) and 1.2% (n=2), respectively (p=0.224). Conclusion. We found no effect of long-term anticoagulation on the incidence of endoleaks in intraoperative and long-term postoperative period. Long-term survival was also comparable. Thus, EVAR under anticoagulation is safe and doesn’t increase the incidence of adverse events in postoperative period.
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Kraynikov et al. (2023) conducted a cohort in Abdominal aortic aneurysm (n=192). Anticoagulation vs. Control group (no anticoagulation) was evaluated on Survival rate (p=0.88). Long-term anticoagulation after endovascular abdominal aortic aneurysm repair did not significantly affect survival (96.4% vs 95.6%, p=0.88) or 30-day endoleak incidence (13.3% vs 10.5%, p=0.65).
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