Work

Outcome Analysis of Pre-Emptive Embolization of the Collateral Branches of the Abdominal Aorta During Standard Infrarenal Endovascular Aortic Repair

Year: 2025

Type: article

Abstract: Objectives. To report the results of the preemptive embolization of the collateral branches of the abdominal aorta in patients undergoing standard bifurcated EVAR. Methods. It is a single-center, retrospective, observational cohort study of consecutive patients treated electively with standard EVAR between October 1st, 2013, and December 31st, 2022, and with a follow-up of 2-years at least. We divided the patients in two groups: no embolization (group A) and preemptive embolization of aortic collateral branches (group B). Primary outcomes were overall survival, freedom from aorta-related mortality (ARM), and freedom from T2E-related reintervention. The secondary outcome was the assessment of freedom from an aneurysm sac increase. Results. We analyzed 265 EVARs: 183 (69.1%) in group A, and 82 (30.9%) in group B. The median follow-up was 48 months [interquartile (IQR), 28-65.5], and it was not different between the two groups (P = 0.098). Estimated cumulative survival was 87% (0.2) at 2 years (95%CI: 82.6-92.9) and 67% (0.3) at 5 years (95%CI: 60.3-73.1) with no difference between the groups (P = 0.263). Aorta-related mortality rate was 1.1% (n = 3), following open conversion for endograft infection (n = 2), and secondary aortic rupture (n = 1). The freedom from T2E-related reintervention was 99% (0.01) at 2 years (95%CI: 99.4-99.8) and 88% (0.3) at 5 years (95%CI: 81.4-92.5): there was no difference between the groups (P = 0.282). Cox’s regression analysis identified age > 80 years as an independent negative predictor for survival (HR: 3.5, 95%CI: 2.27-5.50, P < 0.001), and T2E-related reintervention (HR: 2.4, 95%CI: 1.05-5.54, P = 0.037). Conclusions. Preemptive embolization of the aortic collateral branches does not confer better aor-ta-related outcomes after EVAR.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14072391