To examine the association between changes in proximal seal after infrarenal EVAR and the occurrence of later EL1A, as well as the role of persistent EL2 in identifying patients with seal deterioration.
Approach:
Study Design: A retrospective multicenter study involving patients with fusiform infrarenal AAA undergoing elective or urgent EVAR from November 2012 to November 2022.
Follow-Up Algorithms: Postoperative surveillance included routine CTA within 1 month and at 1 year after EVAR, followed by annual assessments based on local protocols.
Variable Definition: Measurements were derived from axial CTA reconstructions, focusing on sealing length, sealing surface, and other geometric descriptors.
Statistical Analysis: Normality was assessed, and normally distributed variables were compared using the Student t test.
Key Findings:
Proximal sealing length at the first postoperative CTA and its changes were associated with subsequent EL1A.
Persistent EL2 identified a subgroup of patients with less favorable sealing trajectories.
Interpretation:
The study emphasizes the need for monitoring proximal sealing changes over time to predict EL1A.
Limitations:
The study is retrospective and may be subject to selection bias.
Exclusion of certain aneurysm types and adjunctive procedures may limit generalizability.
Conclusion:
Monitoring proximal sealing dynamics post-EVAR is essential for understanding potential complications.
