EVAR in small versus large aneurysms: Does size influence outcome?

Objective: To determine whether there is a difference in outcome between endovascular repair of abdominal aortic aneurysm (EVAR) of small versus large aneurysms. Methods: A total of 192 patients from the Power-link trial were subdivided into small abdominal aortic aneurysms (AAA; ĝ‰Currency sign5 cm) and large AAA (>5 cm) groups. Demographics, perioperative morbidity, mortality, overall survival, and freedom from major adverse events, endoleak, aneurysm-related death, migration, and secondary procedures were assessed. Aneurysmal involvement of the iliacs as well as neck length and angulation was compared between groups. Results: Perioperative morbidity (P = 1.000), mortality (P =.4603), and extent of iliac involvement did not differ between groups (P =.2260). The necks in small AAA were longer (P =.0028) and less angulated (P <.0001). There was no difference in overall survival (P =.6066), freedom from major adverse events (P =.7842), endoleak, (P =.1832), migration (P =.5765), aneurysm-related death (P =.4728), or need for secondary procedures (P =.2323). Conclusion: Under controlled conditions of patient and device selection, there is no significant difference in outcome for EVAR of small versus large AAA.