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Analysis of Outcomes After Endovascular Abdominal Aortic Aneurysm Repair in Patients With Abnormal Findings on the First Postoperative Computed Tomography Angiography
- Source :
- Geraedts , A C M , Mulay , S , van Dieren , S , Koelemay , M J W , Balm , R , Balm , R , Elshof , J W , Elsman , B H P , Hamming , J F , Koelemay , M J W , Kropman , R H J , Poyck , P P , Schurink , G W H , de Smet , A A E A , van Sterkenburg , S M , Ünlü , C , Vahl , A C , Verhagen , H J M , Vriens , P W H E , de Vries , J P P M , Wever , J J , Wisselink , W & Zeebregts , C J 2021 , ' Analysis of Outcomes After Endovascular Abdominal Aortic Aneurysm Repair in Patients With Abnormal Findings on the First Postoperative Computed Tomography Angiography ' , Journal of Endovascular Therapy , vol. 28 , no. 6 , pp. 878-887 .
- Publication Year :
- 2021
-
Abstract
- Purpose: Lifelong follow-up after endovascular abdominal aortic aneurysm repair (EVAR) is recommended due to a continued risk of complications, especially if the first postoperative imaging shows abnormal findings. We studied the long-term outcomes in patients with abnormalities on the first postoperative computed tomography angiography (CTA) following EVAR. Materials and Methods: This is a retrospective study of all consecutive patients who underwent elective EVAR for nonruptured abdominal aortic aneurysm (AAA) between January 2007 and January 2012 in 16 Dutch hospitals with follow-up until December 2018. Patients were included if the first postoperative CTA showed one of the following abnormal findings: endoleak type I–IV, endograft kinking, infection, or limb occlusion. AAA diameter, complications, and secondary interventions during follow-up were registered. Primary endpoint was overall survival, and other endpoints were secondary interventions and intervention-free survival. Kaplan-Meier analyses were used to estimate overall and intervention-free survival. Cox regression analyses were used to identify the association of independent determinants with survival and secondary interventions. Results: A total of 502 patients had abnormal findings on the first postoperative CTA after EVAR and had a median follow-up (interquartile range IQR) of 83.0 months (59.0). The estimated overall survival rate at 1, 5, and 10 years was 84.7%, 51.0%, and 30.8%, respectively. Age [hazard ratio (HR) 1.06, 95% confidence interval (CI) 1.05 to 1.10] and American Society of Anesthesiologists (ASA) classification (ASA IV HR 3.20, 95% CI 1.99 to 5.15) were significantly associated with all-cause mortality. Overall, 167 of the 502 patients (33.3%) underwent 238 secondary interventions in total. Fifty-eight patients (12%) underwent an intervention based on a finding on the first postoperative CTA. Overall survival was 38.4% for patients with secondary interventions and 44.5% for patien
Details
- Database :
- OAIster
- Journal :
- Geraedts , A C M , Mulay , S , van Dieren , S , Koelemay , M J W , Balm , R , Balm , R , Elshof , J W , Elsman , B H P , Hamming , J F , Koelemay , M J W , Kropman , R H J , Poyck , P P , Schurink , G W H , de Smet , A A E A , van Sterkenburg , S M , Ünlü , C , Vahl , A C , Verhagen , H J M , Vriens , P W H E , de Vries , J P P M , Wever , J J , Wisselink , W & Zeebregts , C J 2021 , ' Analysis of Outcomes After Endovascular Abdominal Aortic Aneurysm Repair in Patients With Abnormal Findings on the First Postoperative Computed Tomography Angiography ' , Journal of Endovascular Therapy , vol. 28 , no. 6 , pp. 878-887 .
- Notes :
- application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1379333065
- Document Type :
- Electronic Resource