Late single-center outcome of the Talent Abdominal Stent Graft after a decade of follow-up

Abstract

Lifelong yearly surveillance is advised after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. This follow-up requires a substantial amount of health care resources. The aim of this paper was to assess the occurrence of stentgraft-related complications and secondary interventions during a minimum 10-year follow-up after elective EVAR. Patients who were treated in a high-volume endovascular center in The Netherlands with the Talent infrarenal stent graft (Medtronic Vascular, Santa Rosa, Calif) between June 1999 and February 2005 were included. Patients with previous aortic surgery or emergency interventions were excluded. Our primary outcome was clinical success up to 10years. Secondary end points were technical success and survival. A total of 149 patients were included; 91.9% were male. The mean age was 70.2± 7.8years. A stent graft was implanted in 98% of patients; technical success was achieved in 89.9%. Clinical success after 30days, 1year, 5years, and 10years was 81.1%, 74.3%, 70.3%, and 65.5%, respectively. In 30 patients (20.7%), a secondary intervention was required; 80.0% of first secondary interventions occurred within the first 5years. Six late conversions were necessary because of stent graft infection (2), migration (2), or persisting endoleak (2). The 5- and 10-year overall survival rates were 55.2% and 38.6%, respectively. The risk of EVAR-related complication is highest in the first 5years. Consequently, the main focus should beon that period; further follow-up must not be neglected, as complications occur up to 10years after treatment.