A Preliminary Investigation into the Effects of Immunosuppressive Therapy on Outcomes of Endovascular Aneurysm Repair

Objectives: This study aimed to evaluate the short- and long-term outcomes of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs), with a particular focus on the impact of immunosuppressive therapy. Methods: The authors retrospectively reviewed the institutional data of patients with AAAs who underwent EVAR between 2008 and 2023. Results: A total of 307 consecutive patients underwent elective EVAR for AAA. Of these, 26 patients (8.5%) were receiving immunosuppressive therapy (IT group). Patients in the IT group had a significantly higher incidence of early postoperative complications than those in the non-IT group (42.3% vs. 17.4%). The mean follow-up period was 40.7 ± 33.6 months. The cumulative incidence of sac shrinkage was similar between the groups, whereas the cumulative incidence of sac expansion was significantly higher in the IT group. The rates of reintervention and open aneurysmorrhaphy were also significantly higher in the IT group. The use of immunosuppressive therapy was one of the significant risk factors for late sac expansion (hazard ratio, 4.66, 95% confidence interval, 2.12-10.23). Overall survival was similar regardless of immunosuppressive therapy status. Conclusions: Immunosuppressive therapy may be associated with an increased risk of early postoperative complications and late sac expansion in patients undergoing EVAR.