Expanding Sac and Shrinking Survival Post-Endovascular Aneurysm Repair: Causal Relationship or Prognostic Marker?

This interesting study by Li et al. used data from the ENGAGE registry to investigate the association between sac dynamics (regression vs. stability vs. expansion) and survival following infrarenal endovascular abdominal aortic aneurysm repair (EVAR).1 In a cohort of 949 participants, the all cause mortality rate at five years was 37% for those with sac expansion (46 participants) compared with 20% and 28% for those with sac regression (441 participants) and stable sac size (462 participants), respectively.