The influence of neck thrombus on clinical outcome and aneurysm morphology after endovascular aneurysm repair

Objective: This study investigated the influence of significant aneurysm neck thrombus in clinical and morphologic outcomes after endovascular aneurysm repair (EVAR). Methods: The patient population was derived from a prospective EVAR database from two university institutions in The Netherlands from 2004 to 2008. Patients with significant thrombus in the neck (> 2 mm in thickness in at least > 25% of circumference) were identified as the thrombus group and were compared with the remaining patients without neck thrombus (no-thrombus group), treated within the same period. The primary end point was clinical success. Secondary end points included technical succe Results: The study included 389 patients: 43 (39 men; mean age of 72.3 years) met the criteria for the thrombus group; of these, 31 (72%) had significant thrombus in > 50% of the aortic neck circumference, and 8 (19%) had circumferential thrombus > 2-mm thick. Median follow-up was 3.34 years (interquartile range, 2.67-4.72). The estimated 5-year clinical success rate was 74% for the thrombus group and 62% for the no-thrombus group (P = .23). Endograft migration was more frequent in the thrombus Conclusions: Our findings suggest that the presence of aneurysm neck thrombus has no significant influence on short-term and midterm EVAR results. (J Vasc Surg 2012;)