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Long-term Results of Endovascular Abdominal Aortic Aneurysm Treatment With the First Generation of Commercially Available Stent Grafts
Lina J. Leurs, MSc;
Jacob Buth, MD, PhD;
Robert J. F. Laheij, PhD; for the EUROSTAR Collaborators
Arch Surg. 2007;142(1):33-41.
Hypothesis Little information about the long-term results of endovascular abdominal aortic aneurysm repair is available. This study was performed to evaluate the long-term data of patients treated with the first generation of commercially available stent grafts.
Design Multicenter registry.
Setting Sixty-two European centers that participated in the EUROSTAR (EUROpean collaborators on Stent-graft Techniques for abdominal aortic Aneurysm Repair) registry.
Patients A total of 1190 patients with a follow-up of up to 8 years, who underwent endovascular abdominal aortic aneurysm repair with a stent graft (Stentor or Vanguard).
Intervention Elective endovascular abdominal aortic aneurysm repair.
Main Outcome Measures The morbidity and mortality data of patients treated with the first-generation stent graft who enrolled in the EUROSTAR registry were analyzed. Incidence rates of complications were calculated to quantify annual risks. Life-table analyses and multivariate Cox proportional hazards models were used for the survival analysis.
Results Conversion to open repair, aneurysm rupture, all-cause death, and aneurysm-related death occurred in 7.1%, 2.4%, 19.9%, and 3.0% of the patients, respectively. The cumulative percentage of the combined outcome event, conversion-free and rupture-free survival, after 8 years was 48.0%. Procedure-related complications that frequently occurred were endoleak (13.0 cases per 100 patient-years), stenosis/thrombosis (4.6 cases per 100 patient-years), and stent migration (4.3 cases per 100 patient-years).
Conclusions Patients treated with the first generation of stent grafts will need lifelong surveillance because of a considerable risk of late complications. How these findings translate to the outcome of newer-generation stent grafts is unknown. For this reason, vigilant surveillance remains indicated in all patients who undergo endovascular abdominal aortic aneurysm repair.
Author Affiliations: EUROSTAR Data Registry Centre, Department of Vascular Surgery, Catharina Hospital, Eindhoven, the Netherlands.
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