Abstract 14427: The Effect of Age and Gender on Endoleak and Reintervention After EVAR
Introduction: Endovascular aneurysm repair (EVAR) is an effective treatment strategy for abdominal aortic aneurysm (AAA). The late morbidity associated with repair is often due to the development of endoleak and need for reintervention. In this study, we sought to determine which factors increase the risk of endoleak and the need for subsequent reinterventions.
Methods: All patients enrolled within the prospectively maintained Gore GREAT registry from August 2010 to September 2015 were included. Subjects underwent implantation with a Gore Excluder device for an AAA with a neck angle of less than 120 degrees. Mean follow-up was 408.8 days. The primary endpoints considered were endoleak (Type I or III, Type II), the need for any reintervention and device-specific reintervention. Variables examined included gender, maximal infrarenal neck angle, proximal neck length and age. For each endpoint, a Cox proportional hazards model was performed.
Results: A total of 1,841 patients were registered during the study period of which 280 were female. The mean age at implantation was 73.6 years. The reintervention rate was 24.6% in the female and 17.0% in the male population (p = 0.002). The device related reintervention rate was also significant with a rate of 13.9% of females and 6.4% of males requiring reintervention (p = 0.00002). The rate of endoleak was also higher in females than males, 7.2% versus 3.3% (p = 0.007). Age also was a significant predictor for requiring a reintervention with p = 0.002 when age is applied as a continuous variable in the Cox Model. Neither proximal neck length nor maximal infrarenal neck angle were significant predictors for the need for reintervention nor for the likelihood of developing endoleak when all variables were considered together.
Conclusions: These results provide strong evidence that females have a higher chance of experiencing aortic endoleak as well as a reintervention event. Age also suggests an increased chance for endoleak and need for reintervention. While proximal neck length has an influence on the risk for reintervention, when female gender is added to the model it is not significant, suggesting that gender is the most important predictor for outcomes following EVAR.
Author Disclosures: T. Babrowski: None. R. Milner: Consultant/Advisory Board; Significant; WL Gore, Medtronic, Cook, Endospan.
- © 2016 by American Heart Association, Inc.