Influence of warfarin therapy on the occurrence of postoperative endoleaks and aneurysm sac enlargement after endovascular abdominal aortic aneurysm repair

Yoshimasa Seike, Hiroshi Tanaka, Tetsuya Fukuda, Tatsuya Itonaga, Yoshiaki Morita, Tatsuya Oda, Yosuke Inoue, Hiroaki Sasaki, Kenji Minatoya, Junjiro Kobayashi

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

OBJECTIVES: This study aims to determine whether warfarin therapy influences the occurrence of endoleaks or aneurysm sac enlargement after endovascular aortic repair (EVAR). METHODS: A total of 367 patients who underwent EVAR for abdominal aortic aneurysm between 2007 and 2013 were recruited for this study. Satisfactory follow-up data including completed computed tomography scan follow-up for more than 2 years were available for 209 patients, and the mean follow-up time was 37 ± 12 months. Twenty-nine (16%) patients were on warfarin therapy (warfarin group), whereas 180 (84%) patients were not on warfarin therapy (control group). RESULTS: Two-And four-year freedom rates for persistent type II endoleaks were significantly lower in patients of the warfarin group compared with the control group (85 and 49% vs 93 and 91%, respectively; P = 0.0001). Similarly, 2-And 4-year freedom rates for sac enlargement (>5 mm) were significantly lower in patients of the warfarin group compared with the control group (83 and 61% vs 92 and 82%, respectively; P = 0.0036). Using Cox regression analysis, the warfarin therapy was identified to be an independent positive predictor of sac enlargement after EVAR [hazard ratio (HR): 2.4; 95% confidence interval (CI): 1.08-5.40; P = 0.032], together with persistent type II endoleak. Warfarin therapy was also an independent predictor for persistent type II endoleak (HR: 3.7; 95% CI: 1.81-7.41; P < 0.0001) together with the number of patent lumbar arteries. CONCLUSIONS: Results suggested that warfarin therapy was significantly associated with an increased risk for persistent II endoleak and sac enlargement after EVAR.

Original languageEnglish
Pages (from-to)615-618
Number of pages4
JournalInteractive cardiovascular and thoracic surgery
Volume24
Issue number4
DOIs
Publication statusPublished - 2017
Externally publishedYes

Keywords

  • Abdominal aortic aneurysm
  • Endovascular aneurysm repair
  • Persistent type II endoleak
  • Sac enlargement
  • Warfarin therapy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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