{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:18:47Z","timestamp":1788884327798,"version":"build-2803163510"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":2516,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,5,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aneurysm shrinkage has been proposed as a marker of successful endovascular aneurysm repair (EVAR). Patients with early postoperative shrinkage may experience fewer subsequent complications, and consequently require less intensive surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing EVAR from 2000 to 2011 at three vascular centres (in 2 countries), who had two imaging examinations (postoperative and after 6\u201318 months), were included. Maximum diameter, complications and secondary interventions during follow-up were registered. Patients were categorized according to early sac dynamics. The primary endpoint was freedom from late complications. Secondary endpoints were freedom from secondary intervention, postimplant rupture and direct (type I\/III) endoleaks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Some 597 EVARs (71\u00b71 per cent of all EVARs) were included. No shrinkage was observed in 284 patients (47\u00b76 per cent), moderate shrinkage (5\u20139 mm) in 142 (23\u00b78 per cent) and major shrinkage (at least 10 mm) in 171 patients (28\u00b76 per cent). Four years after the index imaging, the rate of freedom from complications was 84\u00b73 (95 per cent confidence interval 78\u00b77 to 89\u00b78), 88\u00b71 (80\u00b76 to 95\u00b75) and 94\u00b74 (90\u00b71 to 98\u00b77) per cent respectively. No shrinkage was an independent risk factor for late complications compared with major shrinkage (hazard ratio (HR) 3\u00b711; P &amp;lt; 0\u00b7001). Moderate compared with major shrinkage (HR 2\u00b710; P = 0\u00b7022), early postoperative complications (HR 3\u00b734; P &amp;lt; 0\u00b7001) and increasing abdominal aortic aneurysm baseline diameter (HR 1\u00b702; P = 0\u00b7001) were also risk factors for late complications. Freedom from secondary interventions and direct endoleaks was greater for patients with major sac shrinkage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early change in aneurysm sac diameter is a strong predictor of late complications after EVAR. Patients with major sac shrinkage have a very low risk of complications for up to 5 years. This parameter may be used to tailor postoperative surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.9516","type":"journal-article","created":{"date-parts":[[2014,4,22]],"date-time":"2014-04-22T06:09:15Z","timestamp":1398146955000},"page":"802-810","source":"Crossref","is-referenced-by-count":134,"title":["Early sac shrinkage predicts a low risk of late complications after endovascular aortic aneurysm repair"],"prefix":"10.1093","volume":"101","author":[{"given":"F","family":"Bastos Gon\u00e7alves","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands"},{"name":"Department of Angiology and Vascular Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Baderkhan","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden"},{"name":"Department of Surgery, G\u00e4vle County Hospital, G\u00e4vle, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J M","family":"Verhagen","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Wanhainen","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Bj\u00f6rck","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Stolker","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S E","family":"Hoeks","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,4,22]]},"reference":[{"key":"2021031210201567000_bjs9516-bib-0001","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.ejvs.2011.06.043","article-title":"Treatment of abdominal aortic aneurysm in nine countries 2005\u20132009: a Vascunet report","volume":"42","author":"Mani","year":"2011","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2021031210201567000_bjs9516-bib-0002","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1002\/bjs.9101","article-title":"Systematic review and meta-analysis of the early and late outcomes of open and endovascular repair of abdominal aortic aneurysm","volume":"100","author":"Stather","year":"2013","journal-title":"Br J Surg"},{"key":"2021031210201567000_bjs9516-bib-0003","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.crad.2012.11.019","article-title":"Surveillance of patients post-endovascular abdominal aortic aneurysm repair (EVAR). 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