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Short Term and Long Term Clinical Outcomes of Endovascular versus Open Repair for Juxtarenal and Pararenal Abdominal Aortic Aneurysms Using Propensity Score Matching: Results from Juxta- and pararenal aortic Aneurysm Multicentre European Study (JAMES).
- Source :
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European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery [Eur J Vasc Endovasc Surg] 2023 Jun; Vol. 65 (6), pp. 828-836. Date of Electronic Publication: 2023 Feb 27. - Publication Year :
- 2023
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Abstract
- Objective: The aim of this study was to compare the short and long term clinical outcomes of endovascular (EVAR) vs. open surgical repair (OSR) of juxtarenal (JAAAs) and pararenal abdominal aortic aneurysms (PAAAs) in five high volume European academic centres.<br />Methods: This was a retrospective multicentre cohort study of five high volume European academic centres (> 50 open or 50 endovascular abdominal aortic aneurysm repairs annually) including 834 consecutive patients who were operated on and prospectively followed. Using propensity score matching (PSM) each patient who underwent OSR was matched with one patient who underwent EVAR in a 1:1 ratio (145 patients per group). The primary endpoint was long term all cause mortality, while the secondary endpoint was freedom from aortic related re-intervention.<br />Results: After a follow up of 87 months, no difference in overall survival between the two groups was observed (38.6% for EVAR vs. 42.1% for OSR; p = .88). Patients undergoing EVAR underwent aortic related re-interventions more frequently (24.1% vs. 6.9%; p < .001). Acute kidney injury (AKI) occurred more frequently in patients in the OSR group (40.7% vs. 24.8%; p = .006). However, most patients who suffered from AKI recovered without further progression to renal failure. In hospital (3.4% for EVAR vs. 4.1% for OSR; p = 1.0) and 30 day (4.1% for EVAR vs. 5.5% for OSR; p = .80) mortality rates did not differ between groups.<br />Conclusion: Both open and endovascular treatment can be performed in high volume aortic centres with low short term mortality and morbidity rates, and good long term outcomes. These data provide useful information to help patients choose between the two procedures when both are feasible.<br /> (Copyright © 2023 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Cohort Studies
Propensity Score
Retrospective Studies
Treatment Outcome
Postoperative Complications epidemiology
Postoperative Complications etiology
Risk Factors
Blood Vessel Prosthesis Implantation adverse effects
Endovascular Procedures methods
Aortic Aneurysm, Abdominal diagnostic imaging
Aortic Aneurysm, Abdominal surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2165
- Volume :
- 65
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 36858252
- Full Text :
- https://doi.org/10.1016/j.ejvs.2023.02.070