Short and Intermediate Outcome of Endovascular Aortic Aneurysmal Repair, A multicenteric Study

Mohamed Hosny Sayed; Mohammed Ali Hassan; Ahmed Samir Hosny; Hisham Rashid; Mohamed Hosni  El Dessoki

doi:10.3889/oamjms.2021.7384

Authors

Mohamed Hosny Sayed Department of Vascular Surgery, Cairo University Hospitals, Cairo, Egypt https://orcid.org/0000-0002-3804-723X
Mohammed Ali Hassan Department of Vascular Surgery, Cairo University Hospitals, Cairo, Egypt https://orcid.org/0000-0002-4228-780X
Ahmed Samir Hosny Department of Vascular Surgery, Cairo University Hospitals, Cairo, Egypt
Hisham Rashid Department of Vascular Surgery, KCH NHS Foundation Trust, Kings College, London, EnglandDepartment of Vascular Surgery, KCH NHS Foundation Trust, Kings College, London, England https://orcid.org/0000-0002-7160-0738
Mohamed Hosni El Dessoki Department of Vascular Surgery, Cairo University Hospitals, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.7384

Keywords:

Abdominal aortic aneurysms, Endovascular aneurysm repair, Mortality, Complications, Reintervention

Abstract

BACKGROUND: The availability of aortic stent-grafts has permitted an obvious change in the management of abdominal aortic aneurysms (AAA). For elective cases open surgical repair has been widely superseded by the use of stent-graft. With the rapid evolution of the endovascular technology, a significant development in stent-graft techniques was achieved in conjunction with a better understanding of how to utilize stent-grafts.

METHODS: A multicenter prospective study in which 49 patients were enrolled, they underwent an elective endovascular aneurysm repair (EVAR) procedure for infrarenal AAA in two different institutions, Kasr Al-ainy School of Medicine, Cairo University and King’s College Hospital in London, the selected patients were followed up for 6 months after the procedure. Data relating to demographics and pre-operative comorbidities were recorded. Aneurysm morphology was reviewed by computed tomography angiography scans. Clinical data was collected through operative records and afterward through outpatient clinic follow-up sessions.

RESULTS: Overall survival was 94% over a period of 6 months calculated using KaplanMeier Survival Curve.

CONCLUSIONS: Endovascular repair resulted in fewer perioperative deaths. This study provides insight into clinical parameters that can be used to stratify patients’ post-EVAR surveillance and need for re-intervention and it came to the conclusion that EVAR could be considered as the standard repair for uncomplicated infrarenal AAA.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Cronenwett JL, Johnston KW. Rutherford’s Vascular Surgery E-Book. Amsterdam, Netherlands: Elsevier Health Sciences; 2014.

England A, Mc Williams R. Endovascular aortic aneurysm repair (EVAR). Ulster Med J. 2013;82(1):3-10. PMid:23620623

Rich N, Tucker LY, Okuhn S, Hua H, Hill B, Goodney P, et al. Long-term freedom from aneurysm-related mortality remains favorable after endovascular abdominal aortic aneurysm repair in a 15-year multicenter registry. J Vasc Surg. 2020;71(3):790-8. https://doi.org/10.1016/j.jvs.2019.05.043. PMid:31495678 DOI: https://doi.org/10.1016/j.jvs.2019.05.043

Propper BW, Abularrage CJ. Long-term safety and efficacy of endovascular abdominal aortic aneurysm repair. Vasc Health Risk Manag. 2013;9:135-41. https://doi.org/10.2147/vhrm.s32250 PMid:23579199 DOI: https://doi.org/10.2147/VHRM.S32250

De Bruin JL, Baas AF, Buth J, Prinssen M, Verhoeven EL, Cuypers PW, et al. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010;362(20):1881-9. https://doi.org/10.1056/NEJMoa0909499. PMid:20484396 DOI: https://doi.org/10.1056/NEJMoa0909499

Greenhalgh RM, The E. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: Randomised controlled trial. Lancet. 2004;364(9437):843-8. https://doi.org/10.1016/S0140-6736(04)16979-1 PMid:15351191 DOI: https://doi.org/10.1016/S0140-6736(04)16979-1

Lederle FA, Freischlag JA, Kyriakides TC, Matsumura JS, Padberg FT Jr., Kohler TR, et al. Long-term comparison of endovascular and open repair of abdominal aortic aneurysm. N Engl J Med. 2012;367(21):1988-97. https://doi.org/10.1056/nejmoa1207481 PMid:23171095 DOI: https://doi.org/10.1056/NEJMoa1207481

Yalcin M, Tiryakioglu O. Single-center study comparing short and mid-term results of EVAR in old and young populations. Braz J Cardiovasc Surg. 2019;34(3):279-84. https://doi.org/10.21470/1678-9741-2018-0021 Mid:31310465 DOI: https://doi.org/10.21470/1678-9741-2018-0021

Deery SE, Ergul EA, Schermerhorn ML, Siracuse JJ, Schanzer A, Goodney PP, et al. Aneurysm sac expansion is independently associated with late mortality in patients treated with endovascular aneurysm repair. J Vasc Surg. 2018;67(1):157-64. https://doi.org/10.1016/j.jvs.2017.06.075 PMid:28865980 DOI: https://doi.org/10.1016/j.jvs.2017.06.075

Han Y, Zhang S, Zhang J, Ji C, Eckstein HH. Outcomes of endovascular abdominal aortic aneurysm repair in octogenarians: Meta-analysis and systematic review. Eur J Vasc Endovasc Surg. 2017;54(4):454-63. https://doi.org/10.1016/j.ejvs.2017.06.027 PMid:28822680 DOI: https://doi.org/10.1016/j.ejvs.2017.06.027