The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

ludc webb

Nuno Dias

Adjunct professor

ludc webb

Long-term outcomes of infrarenal endovascular aneurysm repair with a commercially available stent graft


  • Mohammed Abdulrasak
  • Björn Sonesson
  • Bharti Singh
  • Timothy Resch
  • Nuno V. Dias

Summary, in English

Objective: To assess the long-term results of elective abdominal aortic aneurysm (AAA) repair with a single stent graft system. Methods: Patients undergoing elective, infrarenal endovascular aneurysm repair (EVAR) with a single-stent graft system between 1998 and 2012 were analyzed retrospectively registering pre-, intra-, and postoperative data. All imaging was reviewed. Data are presented as median and interquartile range unless otherwise stated. Results: A total of 543 patients were included (476 males; 74 [69-79] years). Technical success was achieved in 522 (96.1%) patients. Eight (1.5%) patients died perioperatively. Median imaging follow-up was 5.0 (2.8-8.0) years. Freedom from reinterventions was 72 ± 3% at 10 years. Primary and secondary clinical success rates were 58 ± 3% and 78 ± 2% at 10 years, respectively. Freedom from late AAA-related death was 96 ± 1% and overall survival was 32 ± 2% at 10 years. Late persistent secondary clinical failure occurred in 77 (14.2%) patients. Most of the patients with late failures did not undergo reinterventions (83.1%) because they were unfit (39 patients), refused (5 patients), or had stable mild findings (20 patients). Five patients were converted to open repair (most recent, 2008). Favorable neck anatomy was more common in the second half of the study and was associated with less proximal intraoperative adjuncts. Importantly, it also conferred higher primary and secondary clinical success (P = .001 and P < .0001) and primary and assisted freedom from type I/III endoleaks (P = .002 and P < .0001); along with lower AAA-related mortality rates (P = .008). Conclusions: Elective infrarenal EVAR of asymptomatic AAA with single-stent graft has sustainable long-term results, especially when the aneurysm neck anatomy is favorable. AAA-related death and conversion to open repair are very rare events, but the overall survival after 10 years is quite low. The majority of the patients with persistent failure were unfit or refused further reinterventions or had stable findings. Good patient selection and technical developments may continue to improve the results in the future.

Publishing year







Journal of Vascular Surgery





Document type

Journal article




  • Cardiac and Cardiovascular Systems


  • Abdominal aortic aneurysm
  • Endovascular aortic repair
  • Stent graft




  • ISSN: 0741-5214