title: Evaluation of Aneurysm Neck Angle Change After Endovascular Aneurysm Repair Clinical Investigations.
abstract: OBJECTIVE
  To evaluate the aneurysm neck angle changes and post-endovascular aneurysm repair (EVAR) complications.
  
  
  METHODS
  We retrospectively analyzed 72 cases of elective EVAR for abdominal aortic aneurysm among 109 consecutive cases from December 2005 to April 2014. Patients were divided into angulated and non-angulated groups. The angulated group was defined as neck angulation ≥60°. Neck angle was evaluated pre- and post-EVAR during short- (within 1 month), mid- (3-6 months), and long-term (>1 year) follow-up. Aneurysm sac diameter change, aneurysm neck morphology other than angulation, endoleaks, and other post-procedural complications were also documented.
  
  
  RESULTS
  A total of 34 patients were enrolled in the angulated group. There were no statistical differences in age, sex, follow-up duration, and aneurysm neck profile between the two groups (p > 0.05). Both groups showed statistically significant and consistent decreases in angulation during the follow-up period (p < 0.01). The angulated group revealed 22.45 % more straightening than the non-angulated group. Recoil of the Endurant device occurred in the angulated group. No statistically significant intergroup differences were observed in any endoleaks, complications, or re-intervention rates (p > 0.05). Pre-EVAR angle was the only predictor for post-procedural angle change (p < 0.001).
  
  
  CONCLUSIONS
  EVAR is applicable for patients with highly angulated aneurysm neck and provides consistent neck straightening over long-term follow-up. Recoil was evident in the angulated group using the Endurant device.
authors.affiliation: Endovascular Training Center, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Trong Binh
authors.initials: TB
authors.lastname: Le
authors.affiliation: Endovascular Training Center, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Mi Hyoung
authors.initials: MH
authors.lastname: Moon
authors.affiliation: Department of Radiology, Inha University Hospital, Inha University School of Medicine, 7-206 Sinheung-dong 3-ga, Jung-gu, Incheon, Republic of Korea. radjeon@inha.ac.kr.
authors.forename: Yong Sun
authors.initials: YS
authors.lastname: Jeon
authors.affiliation: Department of Vascular Surgery, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Kee Chun
authors.initials: KC
authors.lastname: Hong
authors.affiliation: Department of Radiology, Inha University Hospital, Inha University School of Medicine, 7-206 Sinheung-dong 3-ga, Jung-gu, Incheon, Republic of Korea.
authors.forename: Soon Gu
authors.initials: SG
authors.lastname: Cho
authors.affiliation: Department of Vascular Surgery, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Keun-Myoung
authors.initials: KM
authors.lastname: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D015607:Stents
keywords: Abdominal aortic aneurysm; Endoleak; Endovascular aneurysm repair; Proximal neck angulation