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A retrospective cohort study evaluated EVAR patients treated from 2014 to 2022, stratifying adherence to SVS recommendations up to five years and examining factors linked to nonadherence and type II endoleak detection. Only 44% adhered to all imaging recommendations with an average 9.7% loss to follow-up per year, while 15.4% developed detected type II endoleaks.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/factors-affecting-post-evar-imaging-surveillance-an-opportunity-for-improvement/461507/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/factors-affecting-post-evar-imaging-surveillance-an-opportunity-for-improvement/461507.png","ImageObject",300,407,{"name":92,"@type":93},"SANS","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-09","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What imaging surveillance objective drives the study after EVAR?","Question",{"text":112,"@type":113},"To ensure appropriate follow-up imaging per SVS guidance to support ongoing patient monitoring and detect endoleaks and other complications over time.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was imaging adherence assessed in the study?",{"text":117,"@type":113},"Patients were stratified by adherence to SVS imaging guidelines for up to five years after surgery, and baseline characteristics were compared between adherence groups.",{"name":119,"@type":110,"acceptedAnswer":120},"Which factor was associated with nonadherence to surveillance?",{"text":121,"@type":113},"Residence more than 50 miles from the institution was an independent risk factor for nonadherence, while the Area Deprivation Index (ADI) was not associated.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461507,1790813003,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090760505,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Article  \nFactors Affecting Post-EVAR Imaging Surveillance: An Opportunity for Improvement †  \nDaniel Gage 1, *, Drayson B. Campbell 2, Michael R. Go 2, Xiaoyi Teng 2 and Kristine Orion 2  \nAcademic Editor: Emmanuel Andrès  \nReceived: 25 September 2025  \nRevised: 7 November 2025  \nAccepted: 16 December 2025  \nPublished: 20 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of General Surgery, The Ohio State University, Columbus, OH 43210, USA  \n2 Department of General Surgery, Division of Vascular Surgery, The Ohio State University, Columbus, OH 43210, USA; [drayson.campbell@osumc.edu](drayson.campbell@osumc.edu) (D.B.C.); [michael.go@osumc.edu](michael.go@osumc.edu) (M.R.G.); [xiaoyi.teng@osumc.edu](xiaoyi.teng@osumc.edu) (X.T.); [kristine.orion@osumc.edu](kristine.orion@osumc.edu) (K.O.)  \n* Correspondence: [daniel.gage@osumc.edu](daniel.gage@osumc.edu)  \n† Presented as an electronic poster at the Midwest Vascular Surgical Society Annual Meeting from 12–14 September 2024 in Chicago, IL, USA.  \nAbstract  \nBackground/Objectives: Appropriate imaging surveillance, established by the Society of Vascular Surgery (SVS), following endovascular aorta repair (EVAR) is critical for patient monitoring. We hypothesized that adherence to follow-up decreases over time, and therefore, the ability to detect endoleaks after EVAR also decreases. Methods: A retrospective cohort study of patients who underwent EVAR from 2014 to 2022 at our institution was completed. Patients were stratified by adherence to SVS guidelines for up to five years postoperatively. Demographics, detection of an endoleak > 30 days postoperatively, distance from our facility, and Area Deprivation Index (ADI) were collected. Comparisons of baseline comorbidities between groups and multivariate logistic regressions were performed using R studio. Results: 395 patients underwent an index EVAR at our institution from 2014–2022 . 174 (44%) of patients adhered to all imaging recommendations, with an average loss to follow-up of 9.7% per year. 61 (15.4%) patients had a detected type II endoleak during the study period. Multivariable analysis identified residence > 50 miles from our institution as an independent risk factor for nonadherence (OR 1.76, p = 0.018) when controlling for age, sex, race, and ADI quartile. Conclusions: Adherence to surveillance guidelines gradually decreases after EVAR, but type II endoleak detection continues to occur years following the operation. While residence greater than 50 miles away was associated with nonadherence, patients’ ADI was not. Our results identify an opportunity for providers who may see patients more frequently to assist in reminding and arranging imaging follow-up for patients following their procedure.  \nKeywords: EVAR; aortic surgery; surveillance; follow-up  \n1. Introduction  \nEndovascular aneurysm repair (EVAR) as a surgical intervention for abdominal aortic aneurysms (AAA) has increased greatly over the past few decades, offering a more minimally invasive approach compared to traditional open aortic aneurysm repair. In 2021, greater than 80% of all aortic aneurysm repairs were performed with EVAR, representing avast majority of all cases [1] .  \nPostoperative imaging surveillance after EVAR is vital to monitor potential complications, and the Society for Vascular Surgery (SVS) Guidelines recommend lifelong imaging  \nsurveillance following this procedure. Computed tomography angiography (CTA) is recommended for all patients for the first time one-month postoperatively to monitor for complications such as migration or endoleak, a process by which blood continues filling the aneurysm sac around the EVAR [2] . Endoleaks are common and can occur in up to 30% of patients following this procedure. Specifically, type II endoleaks are the most common, rep","cbCaic4qRAyN0vhg","https://ap.wps.com/l/cbCaic4qRAyN0vhg","pdf",1153229,11,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction\n# Methods","[{\"question\":\"What imaging surveillance objective drives the study after EVAR?\",\"answer\":\"To ensure appropriate follow-up imaging per SVS guidance to support ongoing patient monitoring and detect endoleaks and other complications over time.\"},{\"question\":\"How was imaging adherence assessed in the study?\",\"answer\":\"Patients were stratified by adherence to SVS imaging guidelines for up to five years after surgery, and baseline characteristics were compared between adherence groups.\"},{\"question\":\"Which factor was associated with nonadherence to surveillance?\",\"answer\":\"Residence more than 50 miles from the institution was an independent risk factor for nonadherence, while the Area Deprivation Index (ADI) was not associated.\"}]","Factors Affecting Post-EVAR Imaging Surveillance: An Opportunity for Improvement | PDF",1790761754,28]