Key result
A multivariate logistic regression model using preoperative parameters correctly identified only 66.7% of patients with AAA shrinkage one year after EVAR.
Why the study?
Patients with a shrinking AAA one year after EVAR have better long-term outcomes than those with a stable AAA, but factors determining whether an AAA will shrink remain unknown.
Cohort (n=174)
While larger preoperative AAA diameter, younger age, and smaller infrarenal β angle predict AAA shrinkage after EVAR, current multivariate models lack sufficient accuracy for clinical implementation.
AAA shrinkage after EVAR was associated with better survival; current models leave open reliable prediction of responders.
Recent studies demonstrate that patients with a shrinking abdominal aortic aneurysm (AAA), one-year after endovascular repair (EVAR), have better long-term outcomes than patients with a stable AAA. It is not known what factors determine whether an AAA will shrink or not. In this study, a range of parameters was investigated to identify their use in differentiating patients that will develop a shrinking AAA from those with a stable AAA one-year after EVAR. Hundred-seventy-four patients (67 shrinking AAA, 107 stable AAA) who underwent elective, infrarenal EVAR were enrolled between 2011–2018. Long-term survival was significantly better in patients with a shrinking AAA, compared to those with a stable AAA (p = 0.038). Larger preoperative maximum AAA diameter was associated with an increased likelihood of developing AAA shrinkage one-year after EVAR—whereas older age and larger preoperative infrarenal β angle were associated with a reduced likelihood of AAA shrinkage. However, this multivariate logistic regression model was only able to correctly identify 66.7% of patients with AAA shrinkage from the total cohort. This is not sufficient for implementation in clinical care, and therefore future research is recommended to dive deeper into AAA anatomy, and explore potential predictors using artificial intelligence and radiomics.
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Rijswijk et al. (2022) conducted a cohort in Abdominal aortic aneurysm (AAA) (n=174). Preoperative parameters (maximum AAA diameter, age, infrarenal β angle) was evaluated on Correct identification of AAA shrinkage. A multivariate logistic regression model using preoperative parameters correctly identified only 66.7% of patients with AAA shrinkage one year after EVAR.
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