Key result
EVAR with supra-renal fixation shows ~85% two-year survival and high freedom from reintervention.
Why the study?
The study was designed to evaluate outcomes regarding endoleaks, reinterventions, and aneurysm-related death in patients undergoing EVAR for abdominal aortoiliac aneurysm using Endurant II and Zenith Flex endografts.
What are the rates of endoleaks, reinterventions, and death in patients with AAA treated with supra-renal fixation EVAR endografts?
Cohort (n=156)
What are the rates of endoleaks, reinterventions, and death in patients with AAA treated with supra-renal fixation EVAR endografts?
Supra-renal fixation endografts for EVAR in AAA demonstrate satisfactory survival and freedom from reintervention at 720 days, with endoleaks and limb graft occlusion being the primary drivers of reintervention.
Supports mid-term durability of supra-renal EVAR in AAA; leaves open need for randomized confirmation and CKD risk mitigation.
BACKGROUND: The main objective of this paper is to evaluate the outcomes regarding endoleaks, reinterventions, and death related to aneurysm complications in patients submitted to endovascular repair (EVAR) for abdominal aortoiliac aneurysm (AAA) using Endurant II (Medtronic) and Zenith Flex (Cook) endografts.METHODS: This was a prospective, consecutive cohort study of patients with AAA who underwent EVAR with the use of Endurant II stent graft and Zenith Flex endograft.RESULTS: A total of 156 patients submitted to EVAR were evaluated. The perioperative mortality was 5.1%, eight patients. There were 28 patients (17.9%) submitted to urgent repair of the aneurysm (expansion or rupture). There were 36 cases (23.1%) of later endoleak most of them Type II endoleak (21 patients, 13.4%). There were 12 cases of Type I endoleak. Moreover, regarding limb graft occlusion (LGO), there were nine patients (5.8%). The overall survival rates in a Kaplan-Meier at 720 days was 84.8% in total cohort. The freedom from reintervention rates in a Kaplan-Meier at 720 days was 92.7% in total cohort. The linear regression analysis for survival rates showed that chronic kidney disease (P=0.03; hazard ratio [HR] 2.82, CI 1.07-4.44), was the only factor related to poorer survival rates in both univariate and multivariate analysis. The linear regression analysis showed that the presence of endoleaks (P<0.001, HR=6.69, CI 2.26-8.48) and limb graft occlusion (P<0.001, HR=8.02, CI 1.60-9.99) were related to reintervention in both univariate and multivariate analysis.CONCLUSIONS: In this present study, supra-renal fixation endografts devices were safe and efficient in treating AAA, with satisfactory results and no renal compromise. The linear regression analysis showed that the presence of endoleaks, and limb graft occlusion were related to higher reintervention rates in both univariate and multivariate analysis.
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Soares et al. (2025) conducted a cohort in abdominal aortoiliac aneurysm (AAA) (n=156). EVAR with supra-renal fixation endografts was evaluated on Outcomes regarding endoleaks, reinterventions, and death related to aneurysm complications. EVAR with supra-renal fixation endografts for abdominal aortoiliac aneurysm resulted in 84.8% overall survival and 92.7% freedom from reintervention at 720 days.
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