Impact of Shaggy Aorta in Patients with Abdominal Aortic Aneurysm Following Open or Endovascular Aneurysm Repair

Abstract

To analyze the impact of the presence of shaggy aorta on 30 day morbidity and mortality and long-term survival in patients undergoing abdominal aortic aneurysm (AAA) repair. This retrospective observational study included 447 consecutive patients who underwent AAA repair between January 2009 and December 2012. The study included 209 patients (47%) having open surgical repair (OSR) and 238 patients (53%) having endovascular aneurysm repair (EVAR). Of the 447 patients having elective AAA repair, 48 patients (11%) had shaggy aorta. Both the OSR (p=.005) and EVAR group (p=.007) demonstrated a higher 30 day morbidity and mortality in patients with shaggy aorta. On multivariate regression analysis, patients with shaggy aorta had 4.1 fold (95% CI=1.7-9.7; p=.002) increase in 30 day morbidity and mortality. According to the Kaplan-Meier analysis, patients with shaggy aorta had significantly decreased long-term overall survival in comparison with the non-shaggy group (log-rank test; p=.005), and this resulted from comorbidities. Shaggy aorta is a prominent risk factor associated with 30 day morbidity and mortality. Poor long-term survival was expected in patients with shaggy aorta.