Long-Term Patency of Visceral Vessels After Thoracoabdominal Aortic Repair

A screening program for abdominal aortic aneurysm (AAA), inviting 65-year-old men, was started in Stockholm in 2010 (2.3 million inhabitants). The aim was to present a long-term follow-up of men participating in screening, as well as AAA repair and ruptures among nonparticipants. Demographics were collected for men with screening detected with AAA 2010 to 2016 (n = 672) and a control group with normal aortas at screening (controls, n = 237). Medical charts and regional Swedvasc (Swedish Vascular registry) data were analyzed for aortic repair for men born 1945 to 1951. Ultrasound maximum aortic diameter (AD) as well as Aortic Size Index (ASI) was recorded. Participation was 78% and prevalence of AAA was 1.2% (n = 672). Aortic repair rates correlated with high ASI and AD. During the study period, 22% of the AAA patients were treated with the elective repair; 35 men in surveillance died (5.2%), non-AAA-related causes (82.9%) dominated, followed by unknown causes among 4 (11.4%), and 2 (5.7%) possibly AAA-related deaths. Abdominal aortic aneurysm rupture rate was higher among nonparticipants (0.096% vs 0.0036%, P < .001). The low dropout rate confirms acceptability of follow-up after screening. The efficacy is shown by the much higher rupture rate among the nonparticipating men.

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Outcomes of open and endovascular repair of inflammatory abdominal aortic aneurysms

Vascular ◽

10.1177/1708538117728865 ◽

2017 ◽

Vol 26 (2) ◽

pp. 203-208 ◽

Cited By ~ 1

Author(s):

África Duque Santos ◽

Andrés Reyes Valdivia ◽

María Asunción Romero Lozano ◽

Enrique Aracil Sanus ◽

Julia Ocaña Guaita ◽

...

Keyword(s):

Open Surgery ◽

Aortic Aneurysms ◽

Endovascular Aortic Repair ◽

Abdominal Aneurysm ◽

Aortic Abdominal Aneurysm ◽

Aortic Repair ◽

Number Of Patients ◽

Repair Group

Objective Reports on inflammatory aortic abdominal aneurysm treatment are scarce. Traditionally, open surgery has been validated as the gold standard of treatment; however, high technical skills are required. Endovascular aortic repair has been suggested as a less invasive treatment by some authors offering good results. The purpose of our study was to report our experience and outcomes in the treatment of inflammatory aortic abdominal aneurysm using both approaches. Material and methods A retrospective review and data collection of all patients treated for inflammatory aortic abdominal aneurysm between 2000 and 2015 was done in one academic center. Diagnosis of inflammatory aortic abdominal aneurysm was based on preoperative CT-scan imaging. Type of treatment, postoperative and long-term morbidity and mortality are described. Abdominal compressive symptoms (hydronephrosis) severity and relief after treatment are described. Results Thirty-four patients with intact inflammatory aortic abdominal aneurysm were included. Twenty-nine (85.3%) patients were treated by open means and the remaining five (14.7%) with endovascular aortic repair. Nearly 90% were considered high-risk patients. Median follow-up was 46 months (range 24–112). The two groups were comparable, except for the age and preoperative hydronephrosis. There was no statistical significance in blood transfusion requirements, intensive care hospitalization, 30-day and long-term mortality between the two groups. Preoperative hydronephrosis was diagnosed in four (13.8%) patients in the open surgery group and three (60%) patients in the endovascular aortic repair group. Improvement of hydronephrosis was recognized in three out of the four patients in the open repair group and two out of the three in the endovascular aortic repair group. Renal function remained stable in both groups during follow-up. Conclusions Open surgery remains a safe and valid option for the treatment of inflammatory aortic abdominal aneurysm. Although our study included a small number of patients with endovascular aortic repair treatment, results are promising. Further randomized controlled studies may be necessary to assess long-term effectiveness of endovascular aortic repair treatment in this disease.

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Long-Term Comparison of Thoracic Endovascular Aortic Repair (TEVAR) to Open Surgery for the Treatment of Thoracic Aortic Aneurysms

Journal of Vascular Surgery ◽

10.1016/j.jvs.2012.11.050 ◽

2013 ◽

Vol 57 (1) ◽

pp. 283

Author(s):

N.D. Desai ◽

K. Burtch ◽

W. Moser

Keyword(s):

Open Surgery ◽

Thoracic Endovascular Aortic Repair ◽

Aortic Aneurysms ◽

Endovascular Aortic Repair ◽

Thoracic Aortic Aneurysms ◽

Aortic Repair

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Short- and Long-term Results of Hybrid Arch and Proximal Descending Thoracic Aortic Repair

Journal of Endovascular Therapy ◽

10.1177/1526602816655446 ◽

2016 ◽

Vol 23 (5) ◽

pp. 783-790 ◽

Cited By ~ 16

Author(s):

Guy Martin ◽

Celia Riga ◽

Richard Gibbs ◽

Michael Jenkins ◽

Mohamad Hamady ◽

...

Keyword(s):

Long Term Results ◽

Aortic Repair ◽

Short And Long Term

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Improved outcomes from endovascular aortic repair in younger patients: Towards improved risk stratification

Vascular ◽

10.1177/1708538119843420 ◽

2019 ◽

Vol 27 (6) ◽

pp. 573-581 ◽

Cited By ~ 1

Author(s):

Wan Chin Hsieh ◽

Chung Dann Kan ◽

Chong Chao Hsieh ◽

Mohamed Omara ◽

Brandon Michael Henry ◽

...

Keyword(s):

Open Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Endovascular Aortic Repair ◽

Younger Patients ◽

Aortic Repair ◽

Abdominal Aortic ◽

Short And Long Term ◽

Long Term Mortality

Objectives Abdominal aortic aneurysms are conventionally treated by open repair surgery. While endovascular aortic repair improves survival in high-risk patients, younger patients (40–65 years) potentially at lower risk with asymptomatic abdominal aortic aneurysms undergoing endovascular aortic repair usually have poorer post-operative outcomes and require longer term follow-up. In this study, clinical data on younger patients were analyzed to investigate whether endovascular aortic repair leads to poorer short- and long-term outcomes. Methods This was a systematic review and meta-analysis of articles comparing clinical outcomes in patients aged 40–65 years undergoing open repair or endovascular aortic repair and published between 2000 and 2017. In-hospital mortality, long-term mortality, and post-operative complication data were retrieved from eligible studies and clinical outcomes were compared. Twenty-one retrospective cohort analyses were included, accounting for 250,837 patients (149,051 endovascular aortic repair; 101,786 open repair). Risk ratios were pooled using the DerSimonian and Laird random effects model. All statistical analyses were performed in Review Manager 5.3. Results Younger patients with asymptomatic abdominal aortic aneurysms undergoing endovascular aortic repair had a significantly reduced 30-day mortality (odds ratio (OR) = 0.40, 95% confidence intervals (CI) 0.28–0.57; p < 0.00001), long-term mortality (OR = 0.37, 95% CI 0.17–0.82; p = 0.01), incidence of reintervention (OR = 0.47, 95% CI 0.34–0.66; p < 0.0001), and incidence of renal failure (OR = 1.58, 95% CI 1.37–1.82; p < 0.00001). Conclusions Endovascular aortic repair may improve short- and long-term survival and reduce post-operative complications in younger patients with asymptomatic abdominal aortic aneurysms.

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