{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:48:35Z","timestamp":1792129715143,"version":"4.4.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2012,9,28]],"date-time":"2012-09-28T00:00:00Z","timestamp":1348790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Long-term concerns about the durability of endovascular aortic aneurysm repair (EVAR) remain after the publication of controlled trials. Increased expertise in endograft technology, case selection and postoperative reintervention has created a need for reappraisal of the longer-term efficacy of EVAR using contemporary data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients undergoing infrarenal EVAR between 2004 and 2010 were studied prospectively. Morphological compliance with manufacturers' instructions for use (IFU) was established using three-dimensional computed tomography. The primary outcome measures were all-cause and aneurysm-related mortality, postoperative rupture, reintervention and sac expansion. These adverse events were reported using Kaplan\u2013Meier survival analysis, with comparison within, or outside IFU by the log rank test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 478 patients of median age 76 years had a median aneurysm diameter of 62\u00b79 mm. Median follow-up was 44 (range 11\u201394) months; 198 (41\u00b74 per cent) were compliant with IFU. The 30-day mortality rate was 2\u00b71 per cent (10 of 478 patients): nine (2\u00b70 per cent) of 455 patients who had elective and one (4 per cent) of 23 patients who had non-elective surgery. Aneurysm-related mortality was 0\u00b7897 deaths per 100 person-years, and all-cause mortality was 8\u00b7558 deaths per 100 person-years, with significantly lower survival outside IFU (P = 0\u00b7012). Two patients had a late rupture (0\u00b7138 per 100 person-years), of whom one died. There were 6\u00b7120 reinterventions per 100 person-years, with no difference for aneurysms treated outside IFU (P = 0\u00b7136). Primary sac expansion occurred in 6\u00b7721 per 100 person-years and secondary sac expansion in 4\u00b7142 per 100 person-years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this series EVAR had a lower aneurysm-related mortality rate than demonstrated in early controlled trials, and with lower sac expansion rates than reported from image repositories. Data from earlier studies should be applied to current practice with caution.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.8938","type":"journal-article","created":{"date-parts":[[2012,9,30]],"date-time":"2012-09-30T13:38:09Z","timestamp":1349012289000},"page":"1657-1664","source":"Crossref","is-referenced-by-count":32,"title":["Aortic rupture and sac expansion after endovascular repair of abdominal aortic aneurysm"],"prefix":"10.1093","volume":"99","author":[{"given":"P J E","family":"Holt","sequence":"first","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Karthikesalingam","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B O","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Ghatwary","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Hinchliffe","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I M","family":"Loftus","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M M","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research, St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2012,9,28]]},"reference":[{"key":"2021031606554641600_bib1","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1056\/NEJMoa0909499","article-title":"Long-term outcome of open or endovascular repair of abdominal aortic aneurysm","volume":"362","author":"De Bruin","year":"2010","journal-title":"N Engl J Med"},{"key":"2021031606554641600_bib2","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1056\/NEJMoa0909305","article-title":"Endovascular versus open repair of abdominal aortic aneurysm","volume":"362","author":"Greenhalgh","year":"2010","journal-title":"N Engl J 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