Evaluation of mid – term outcomes of endovascular intervention for infrarenal abdominal aortic aneurysm using computed tomography imaging

Abstract: Overview: In recent years, endovascular intervention has become a widely adopted treatment modality for infrarenal abdominal aortic aneurysms, particularly in elderly patients or those with multiple comorbidities. Compared with conventional open surgery, this approach is associated with reduced invasiveness and shorter post-procedural recovery time. Objectives: The primary objective of this study was to evaluate the mid – term outcomes of endovascular stent – graft repair in the treatment of infrarenal abdominal aortic aneurysms. A secondary objective was to analyze the association between proximal neck anatomical characteristics and treatment outcomes. Methods: This retrospective, cross – sectional descriptive study included patients diagnosed with infrarenal abdominal aortic aneurysms, with or without concomitant common iliac artery aneurysms, who underwent endovascular stent – graft repair at Cho Ray Hospital between January 2017 and December 2024. Results: A total of 119 patients (79,8% male) with a mean age of 71,6 ± 7,2 years were included. Of these, 68 cases were classified into the favorable neck group and 51 cases into hostile neck group. The most common presenting symptom was abdominal pain (67,2%). Hypertension was the most prevalent comorbidity (95%). The mean aneurysm diameter was 63 ± 12,5 mm, with fusiform morphology accounting for the majority (95,8%). Concomitant common iliac artery aneurysms were observed in 37,8% of patients. The technical success rate was 93,3%. Intraoperative endoleaks occurred in 21,8%, predominantly type II (15,1%). The rate of late endoleaks was 10,9%, consisting of type I (5,9%), type II (4,2%) and type III (0,8%). Graft migration occurred in 0,8%, graft occlusion in 1,7%, and graft infection in 0,8% of patients. Aneurysm sac enlargement during follow – up was observed in 5% of cases. The reintervention rate was 1,7%. Patients in the hostile neck group was older than those in the favorable neck group (73,2 vs. 70,4 years, p= 0,03). The proportion of female patients was also higher in the hostile neck group (35,3% vs. 8,8%, p< 0,001). No significant differences were observed between the two groups regarding intraoperative or late endoleak rates. Conclusions: Endovascular stent – graft repair for abdominal aortic aneurysm is a safe and effective technique, with a relatively high technical success rate. The mid – term outcomes are favorable.