Background: To evaluate the 4-year results of the Endurant stent-graft in the treatment of abdominal aortic aneurysm (AAA) or common iliac artery aneurysm (CIAA).
Methods: Between June 2012 and January 2014, 50 consecutive Japanese AAA and CIAA patients were treated with the Endurant stent-graft at Tokyo Medical University Hospital.
Results: Estimated freedom from overall mortality, aneurysm-related mortality, and secondary interventions at 4 years was 61.7%, 97.9%, and 78.6%, respectively. At 4 years, the maximum sac diameter decreased by >5 mm in 24% of the patients, remained stable in 52%, and increased by >5 mm in 24%. The average aneurysm sac reduction was 0.4 to 1.3 mm within 5 years. Multivariate analyses detected female gender (HR: 7.40, P=0.021) and type IV endoleak (HR: 5.34, P=0.009) as a significant risk factor for secondary intervention.
Conclusions: Four-year clinical outcomes of the Endurant stent-graft remained positive in Japanese patients with AAA and CIAA, although 24% of the patients needed a secondary intervention. The aneurysm sac was stable in most of the patients, whereas the aneurysm sac reduction was small. These results suggest that careful imaging follow-up must be continued to determine the durability of the Endurant stent-graft in patients with small aneurysm sac reduction.