Key result
Sac regression post-EVAR is linked to lower mortality and fewer complications versus stable or expanded sacs.
Why the study?
The relationship between sac regression post-EVAR and clinical outcomes in AAA, as well as the impact of EVAR device choice on sac regression, required investigation.
Does sac regression post-EVAR improve clinical outcomes in patients with abdominal aortic aneurysm?
Does sac regression post-EVAR improve clinical outcomes in patients with abdominal aortic aneurysm?
Sac regression post-EVAR is an important prognostic factor associated with improved mortality and morbidity in patients with abdominal aortic aneurysm.
INTRODUCTION: Endovascular aneurysm repair (EVAR) has rapidly become the preferred management of abdominal aortic aneurysm (AAA). Sac regression status post-EVAR has been linked to clinical outcomes as well as the choice of EVAR device. The aim of this narrative review is to investigate the relationship between sac regression and clinical outcomes post-EVAR in AAA. Another aim is to compare sac regression achieved with the main EVAR devices. AREAS COVERED: We carried out a comprehensive literature search on multiple electronic databases. Sac regression was usually defined as a decrease in the sac diameter (>10 mm) over follow-up. This revealed that individuals who had sac regression post-EVAR had significantly lower mortality, and higher event-free survival rates. Further, lower rates of endoleak and reintervention were observed in patients with regressing aneurysm sacs. Sac regression patients also had significantly lower odds of rupture compared to counterparts with stable or expanded sacs. The choice of EVAR device was also shown to impact regression, with the Fenestrated Anaconda showing favorable results. EXPERT OPINION: Sac regression post-EVAR in AAA is an important prognostic factor as it translates to improved mortality and morbidity. Therefore, this relationship must be seriously taken into consideration during follow-up.
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Al‐Tawil et al. (2023) conducted a review in Abdominal aortic aneurysm. Sac regression post-EVAR vs. Stable or expanded sacs was evaluated on Mortality, event-free survival, endoleak, reintervention, and rupture. Sac regression post-EVAR in abdominal aortic aneurysm is associated with significantly lower mortality, higher event-free survival, and lower rates of endoleak, reintervention, and rupture.
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