{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:02:10Z","timestamp":1793408530882,"version":"4.5.0"},"reference-count":51,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To measure the long-term proximal aortic neck dilatation (AND) after elective endovascular aortic aneurysm repair (EVAR) with a variety of contemporary, third-generation, endograft devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This is a noninterventional prospective cohort study of 157 patients that underwent standard EVAR with self-expanding abdominal endografts. Patients\u2019 recruitment lasted from 2013 to 2017, and postoperative follow-up was up to 5 years. A computed tomography angiography (CTA) was performed at the first month and then at 1, 2, and 5 years. Proximal aortic neck\u2019s (PAN) basic morphological characteristics (diameter, length, angulation) were measured based on the analysis of CTA in a standardized fashion. Neck-related adverse events, such as migration, endoleak or rupture, and reinterventions were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Significant straightening of the PAN was evident even in the first-month CTA with concurrent neck shortening that became significant at 5 years. Both the suprarenal aorta and the PAN significantly dilated overtime, with PAN dilating more progressively. Mean neck dilatation at the juxtarenal level was 0.8\u00b10.4 mm at 1 year, 1.8\u00b10.8 mm at 2 years, and 3.9\u00b11.7 mm at 5 years, with a mean neck dilatation rate of 0.07 mm\/month overall. The incidence of AND \u22652.5 mm was 37.2% at 2 years and 58.1% at 5 years after EVAR and was considered important (\u22655 mm) in 11.5% of patients at 2 years and 30.6% of patients at 5 years. A multivariate analysis performed showed that the endograft oversizing, the preoperative neck diameter, and the preoperative abdominal aortic aneurysm sac diameter served as independent predictors of AND at 5 years. At the 5-year follow-up, 8 late type Ia endoleaks (6.5%) and 7 caudal migrations (5.6%) were identified, while no late ruptures were reported. In total, 11 late endovascular reinterventions (8.9%) were performed. Overall, proximal neck-related adverse outcomes (5\/7 migrations and 5\/8 endoleaks) and reinterventions (7\/11) were significantly associated with the presence of important late AND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Proximal AND after EVAR is common. It can influence the long-term durability of proximal endograft fixation and is significantly associated with adverse outcomes, often leading to reinterventions. A systemic and extended surveillance protocol is needed for maintenance of good long-term results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This is a thorough and systematic analysis of the long-term geometric remodeling of the proximal aortic neck after EVAR, that highlights the importance of a strict, and extended surveillance protocol for maintenance of good long-term results of EVAR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028231167998","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T10:56:04Z","timestamp":1681988164000},"page":"87-99","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Long-term Evaluation of Proximal Aortic Neck Dilatation After Endovascular Abdominal Aortic Aneurysm Repair With a Variety of Contemporary Endografts"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1957-5539","authenticated-orcid":false,"given":"Dimitrios A.","family":"Chatzelas","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cG. Gennimatas\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4999-7561","authenticated-orcid":false,"given":"Apostolos G.","family":"Pitoulias","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cG. Gennimatas\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalampos N.","family":"Loutradis","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cG. Gennimatas\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodosia N.","family":"Zampaka","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cG. Gennimatas\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos D.","family":"Karkos","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, 5th Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cHippocration\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios C.","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cG. Gennimatas\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6862-2709","authenticated-orcid":false,"given":"Georgios A.","family":"Pitoulias","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, 2nd Department of Surgery, Faculty of Medicine, School of Health Sciences, \u201cG. Gennimatas\u201d Thessaloniki General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 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