Fatores de risco para crescimento do saco aneurismático pós‐endovascular aneurysm repair: revisão de literatura

About 75% of the Abdominal Aortic Aneurysms (AAA) are currently repaired by endovacular means (EVAR). Aneurysm sac shrinkage post‐EVAR represents the principal marker of absence of rupture or mortality aneurysm related. However, in about 40% of cases aneurysm sac does not shrink or even enlarges.

Several pre‐operative risk factors may predict aneurysm sac enlargement post‐EVAR. The aim of this review is to summarize all risk factors that may condition an aneurysm sac enlargement so that one could adapt the best follow‐up method to each patient according to the risk score.

Most of those risk factors are described in this review: advanced age, hostile necks, endoleak occurrence or even systemic inflammation. These constitute important determinants that predict a worst prognosis pre‐operatively.

The early identification of these risk factors have remarkable implications in the follow up strategy. Patients with none or only one risk factor may be suitable for a US‐Dupplex follow‐up, while those patients with several pre‐operative risk factors could be good candidates for Angio‐Computed Tomography surveillance, which presents more sensivity in the detection of complications, despite its greater iatrogeny.