title: Late events and mid-term results after endovascular aneurysm repair.
abstract: OBJECTIVE
  To evaluate the late events and mid-term results after endovascular aneurysm repair (EVAR).
  
  
  METHODS
  Between December 2006 and May 2012, 175 abdominal aortic aneurysms were treated by EVAR. Aneurysm-related events were analyzed.
  
  
  RESULTS
  The complications that occurred during the EVAR procedure were renal artery occlusion in two patients, access artery injury in two, delivery failure in one, retrograde aortic dissection in one, and death from hepatic failure in one patient. Five adverse endoleaks (four type I, one type III) remained at discharge, and the technical success rate was 97 %. On follow-up, limb occlusion had occurred in five patients. Unilateral renal atrophy was found in three patients, but none of the patients required new hemodialysis. Sac enlargement (≥5 mm) developed in ten patients. Their culprit endoleaks were type Ia in one, II in eight, and V in one patient. Transarterial embolization was performed for three out of the eight type II endoleaks. The rate of freedom from secondary re-intervention was 93 % at 3 and 5 years, respectively. The survival and freedom from aneurysm-related events rates were 74 % at 3 years and 47 % at 5 years.
  
  
  CONCLUSIONS
  The mid-term results of EVAR were excellent with a low rate of aneurysm-related deaths, although there were relatively high aneurysm-related event rates. Sac re-enlargement from type II endoleaks was the most common major issue at the mid-term follow-up.
authors.affiliation: Department of Vascular Surgery, Aichi Medical University Hospital, Nagakute, Aichi, 480-1195, Japan, ishibash@aichi-med-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Ishibashi
authors.forename: T
authors.initials: T
authors.lastname: Ishiguchi
authors.forename: T
authors.initials: T
authors.lastname: Ohta
authors.forename: I
authors.initials: I
authors.lastname: Sugimoto
authors.forename: H
authors.initials: H
authors.lastname: Iwata
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: M
authors.initials: M
authors.lastname: Tadakoshi
authors.forename: N
authors.initials: N
authors.lastname: Hida
authors.forename: Y
authors.initials: Y
authors.lastname: Orimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000453:epidemiology; D000784:Aortic Dissection / Q000453:epidemiology; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001158:Arteries / Q000293:injuries; D001284:Atrophy / Q000453:epidemiology; D018572:Disease-Free Survival; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012078:Renal Artery Obstruction / Q000453:epidemiology; D013997:Time Factors