Midterm follow‐up of 1000 patients in the Registry of Endovascular Treatment of Abdominal Aortic Aneurysms (RETA)

Background: The aim was to present the midterm follow‐up data of patients in the Registry of Endovascular Treatment of Abdominal Aortic Aneurysms (RETA). Methods: RETA now has a cohort of 1000 registered patients. Follow‐up data are available for 483 patients at 1 year (80·8 per cent follow‐up rate), 191 at 2 years (78·0 per cent follow‐up rate) and 64 at 3 years (64·0 per cent follow‐up rate). Results: The mortality rates were 10·8, 12·6 and 6·3 per cent at 1, 2 and 3 years' follow‐up respectively. The majority of deaths at follow‐up were unrelated to the endovascular aneurysm repair. However, ruptures have occurred, with five (1·0 per cent) occurring in the first year of follow‐up and three (1·6 per cent) reported in the second year of follow‐up. This gives a cumulative risk of rupture of 1·0 per cent at 1 year and 2·6 per cent at 2 and 3 years. Three of the ruptures had persisting primary proximal endoleaks and two had documented secondary endoleaks. Complications related to the aneurysm or device occurred in 11·1, 14·8 and 12·8 per cent of cases at 1, 2 and 3 years' follow‐up. The commonest problems were secondary endoleaks, although most of these had successful endovascular treatment. Graft or limb occlusions were the next most common problems. Follow‐up of patients having secondary procedures with endovascular treatment suggests these treatments are durable, although the numbers at present are small. The cumulative endoleak‐free survival rate was 73·4, 57·9 and 49·9 per cent, and the cumulative freedom from endoleak rate was 88·3, 81·2 and 75·6 per cent at 1, 2 and 3 years' follow‐up respectively. Conclusion: Most deaths occurring at follow‐up are not related to the aortic aneursyms. Ruptures have occurred, some related to primary proximal type I endoleaks. Others may be related to secondary endoleaks that have not been detected. Late complications related to the device or aneurysm occur at a rate of about 10 per cent per year. Most frequently these are new endoleaks and are amenable to endovascular treatment, but recurrence may occur, so continued surveillance is necessary. © 2001 British Journal of Surgery Society Ltd