Do Abdominal Aortic Aneurysm Necks Increase in Size Faster after Endovascular than Open Repair?

IntroductionProgression of aneurysmal disease in the aortic neck poses a threat to durable abdominal aortic aneurysm (AAA) repair. We tested the hypothesis that 2 years after AAA repair the size of the aortic neck increased more after endovascular (EVAR) than open repair.Patients and methodsFor a subset of EVAR 1 trial patients, true outer-wall area at three levels of the aortic neck was measured using a Vitrea2 workstation, and rate of change over 2 years analysed.ResultsThe 67 EVAR patients and 56 open repair patients were well-matched, very similar to the total EVAR 1 cohort. The mean area change over 2 years at the Superior Mesenteric Artery was small for both groups. However at the Caudal Renal Artery (CRA), adjusted regression coefficient was 0.68cm2/y greater after EVAR (p<0.001) and 0.77cm2/y at a level 15mm distal to it (p