“Sac regression should be the new paradigm of success after EVAR [endovascular aneurysm repair],” concluded Dittmar Böckler (University of Heidelberg, Heidelberg, Germany) at the European Society for Vascular Surgery (ESVS) 2020 annual meeting (ESVS Month; 29 September–29 October, virtual).
New data from the ENGAGE (OUS) real-world, global post-market registry evaluating the safety and effectiveness of the Medtronic Endurant stent graft system demonstrated that sac regression at one year (n=441) with Endurant is associated with decreased risk of all-cause mortality through five years.
- Through five years, freedom from all-cause mortality among subjects whose sac diameter decreased at one year (n=441) was significantly higher (80% vs. 71.9%) compared to subjects whose sac diameter remained stable at one year (n=462) and compared to subjects whose sac diameter increased at one year (62.6% FF all-cause mortality, n=46).
Furthermore, it was found that sac regression with Endurant at one year is likely to persist through five years and patients have better outcomes. Results also suggested that stable sacs may not be as benign as once thought.
- At five years follow-up (n-470), 63.8% of patients treated with Endurant demonstrated a sac diameter decrease, whereas 25.1% and 11.1% of patients treated with Endurant demonstrated stable sac and increasing sac diameters, respectively.
- Of subjects with sac regression at one year, 86% continue to have sac regression at five years and only 2% have sac increase at five years and 18% have sac increase at five years (n=213).