Mortality for Open Abdominal Aortic Aneurysm Repair before and after Endovascular Aortic Repair (EVAR)

2019 ◽  
Vol 85 (12) ◽  
pp. 1341-1344
Author(s):  
Alex D. Ammar
Keyword(s):  
Tertiary Care ◽  
Study Groups ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Inhospital Mortality ◽  
Vascular Surgeon ◽  
Care Community ◽  
Aortic Repair ◽  
Abdominal Aortic

The purpose of this study was to determine whether endovascular aortic repair (EVAR) has impacted inhospital mortality for patients undergoing open repair (OR). From 1982 through 2016, 1572 repairs were performed for abdominal aortic aneurysms (AAAs). Both ORs and EVARs were performed by the author at two large, tertiary-care, community-based hospitals. In Period I (1982–1999, n = 863), all AAA repairs were performed open. In Period II (2000–2016; n = 709), repairs were performed both by ORs and EVARs. Demographics were similar between study groups. Mortality for elective repairs in Periods I and II were as follows: I = 1.2 per cent (open, n = 9/756) versus II = 1.7 per cent (open, n = 4/241) versus II = 1.2 per cent (EVAR, n = 5/420). Mortality for patients with ruptured AAAs in Periods I and II were as follows: I = 31.8 per cent (open, n = 34/107) versus II = 32 per cent (open, n = 8/25) versus II = 13 per cent (EVAR, n = 3/23). The results of this study demonstrate that the introduction of EVARs has not negatively impacted the inhospital mortality for elective ORs or emergent AAAs for one vascular surgeon who completed training before EVARs became available.

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

Vascular ◽  
2019 ◽  
Vol 27 (6) ◽  
pp. 573-581 ◽  
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.

scholarly journals Splenic Artery Infarction after Successful Management of Abdominal Aortic Aneurysm with Endovascular Stenting; a Case Report

2016 ◽  
Vol 8 ◽  
Author(s):  
Cengiz Ozturk ◽  
Mehmet Ali Sahin ◽  
Ugur Bozlar ◽  
Siddik Erdogan ◽  
Adem Guler ◽  
...  
Keyword(s):  
Splenic Artery ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Font Size ◽  
Endovascular Stenting ◽  
Successful Management ◽  
Post Procedure ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
Endovascular Technology

<p style="margin: 0cm 0cm 10pt; text-align: justify; line-height: 200%; text-indent: 35.4pt; -ms-text-justify: inter-ideograph;"><span style="line-height: 200%; font-family: 'Times New Roman','serif'; font-size: 12pt;">The endovascular aortic repair (EVAR) is the treatment of choice for the majority of patients with abdominal aortic aneurysms(AAA) by supporting endovascular technology. But there are some potential complications during or post procedure. We present a case who underwent endovascular aortic repair (EVAR) for an AAA occured splenic artery infarction after procedure.</span></p>

Endovascular treatment of proximal para-anastomotic aneurysms after previous surgical repair of infrarenal aortic aneurysms by the chimney technique

Vascular ◽  
2018 ◽  
Vol 27 (1) ◽  
pp. 3-7
Author(s):  
Georgios I Karaolanis ◽  
Marco Damiano Pipitone ◽  
Giovanni Torsello ◽  
Martin Austermann ◽  
Konstantinos P Donas
Keyword(s):  
Endovascular Repair ◽  
Open Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Short Neck ◽  
Aortic Repair ◽  
Aortic Neck ◽  
Abdominal Aortic

Objectives To evaluate the use of chimney grafts in the treatment of para-anastomotic aneurysms after previous abdominal aortic aneurysms open repair with short neck. Methods A retrospective analysis of prospectively collected data of consecutive patients who underwent endovascular repair for proximal aortic para-anastomotic aneurysms following previous open repair for infrarenal abdominal aortic aneurysms was performed. All included patients had a short infrarenal aortic neck (<10 mm) excluding standard endovascular aortic repair. Five patients were symptomatic at the admission needed urgent treatment. Results Twelve patients with para-anastomotic aneurysms underwent placement of chimney grafts. The median time between the original operations to redo endovascular procedure was 11 years (interquartile range, 9.5 years). The mean infrarenal length was 4.3 mm (1–9 mm). A total of 28 chimneys grafts were deployed for the 12 patients. The technical success rate was 91.7%. At a median radiologic follow-up of 16 months (2.0–29.4, 95% confidence interval), one patient died, while two late endoleaks and two reinterventions at one and three years for type Ia endoleak were performed by proximal extension and triple chimney graft placement. Conclusion The results of the present study show that ch-endovascular aortic repair is a safe technique for patients who suffered from proximal para-anastomotic aneurysms and having short neck unsuitable for standard endovascular repair. Longer follow up warranted to evaluate the durability of ch-endovascular aortic repair for this specific indication.

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