This study states that Aortic neck degeneration after endovascular aneurysm repair (EVAR) has been implicated in the long-term development of endoleak and the subsequent reintervention. Optimal endograft sizing is a vital aspect to successful repair. This study looked at percentage of graft oversizing as well as type of fixation on aortic neck degeneration.

We retrospectively evaluated all EVARs completed at Loyola University from 2006 to 2015 after Institutional Review Board approval. Exclusion criteria were patients without follow-up scans within a year. We collected demographics, comorbidities, graft type, size, aortic neck diameter, and maximum sac size diameters from the preoperative and follow-up scans. We reviewed and collected data of 432 patients but analyzed 154. We measured the largest aortic diameter on axial images 1 cm above and 1 cm below the renal arteries. Change in suprarenal and infrarenal aortic measurements were evaluated by calculating the millimeter difference from each scan compared with the preoperative scan. Linear mixed effects models were used to estimate patients’ mean differences over time.

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