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Endovascular Abdominal Aortic Aneurysm Repair (endovascular + abdominal_aortic_aneurysm_repair)

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Medical Sciences100%

Selected Abstracts

ENDOVASCULAR ABDOMINAL AORTIC ANEURYSM REPAIR: A 7 YEAR EXPERIENCE AT THE LAUNCESTON GENERAL HOSPITAL

ANZ JOURNAL OF SURGERY, Issue 5 2005
Kate L. A. Borchard
Background: To review our 7 year experience of endovascular abdominal aortic aneurysm repair (EVR) and to compare this to open repair (OR) during the same time period. Methods: One hundred and one EVR and 65 OR patients were studied. Parameters analysed included patient and procedure details, intensive care unit (ICU) and hospital admission time, and morbidity and mortality with particular emphasis on procedure-related problems. Results: Endovascular grafts were deployed with successful abdominal aortic aneurysm (AAA) exclusion in 100 patients. Primary technical success was achieved in 84%, clinical success in 86% and secondary success in 90% of cases. Complications occurred in 63% and 88% of EVR and OR patients, respectively. Early device-related complications occurred in 40 EVR patients (40%); 24 (60%) were corrected immediately by further stenting. Late device-related complications occurred in 15 EVR patients (15%); four (27%) required additional stenting. Most of the complications in the OR group were systemic (89%) resulting in longer ICU and hospital stays (median 48 vs 17 h and 13 vs 4 days for OR and EVR, respectively). Death within 30 days of the procedure occurred in three EVR patients. There was no perioperative mortality in the OR group. Conclusion: Endovascular AAA repair can be undertaken successfully in a district general hospital. The majority of local and device-related complications can be corrected immediately, while those persisting beyond the initial procedure usually resolve spontaneously. EVR offers a minimally invasive approach to a problem that in the past has involved major surgery. [source]

Endovascular Abdominal Aortic Aneurysm Repair by Interventional Cardiologists,A Community-Based Experience

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2010
ABHIJEET BASOOR M.D.
Introduction:,Endovascular repair of abdominal aortic aneurysm (AAA) is a relatively recent technology. In comparison to the conventional open surgical treatment for AAA, endovascular AAA repair (EVAR) combines a less-invasive approach with lower morbidity and mortality. There have been few studies regarding the performance of this procedure in a community-based setting. We report our experience of EVAR performed primarily by interventional cardiologists in a community hospital. Methods:,In our community hospital setting, between September 2005 and November 2007, we included all patients who underwent EVAR by interventional cardiologists, with available on-site vascular surgical support. Clinical and serial computed angiographic imaging outcomes were followed by a retrospective chart review. Data collection tools included demographic and clinical characteristics, anatomical aneurysm features, length of stay, peri- and postprocedural complications, and mortality. Results:,A total of 71 consecutive patients had EVAR attempted. The endovascular stent placement was successful in 67 (93%) patients. Thirty-day mortality in this study was 1 of 71 (1.4%). All four procedural failures and the single periprocedural mortality occurred in women. Mean follow-up was 12 months. There were a total of six mortalities and among these four were women (P , 0.001); however, multivariate analysis revealed loss of significant difference in mortality (P = 0.16). Major complications following EVAR were noted in 10 of 71 (14%) patients. Conclusion:,EVAR can be successfully performed by experienced interventional cardiologists with vascular surgical support in a community-based setting. In our experience, there is acceptable rate of complications and mortality in a carefully selected patient population. (J Interven Cardiol 2010;23:485,490) [source]

ENDOVASCULAR ABDOMINAL AORTIC ANEURYSM REPAIR: A 7 YEAR EXPERIENCE AT THE LAUNCESTON GENERAL HOSPITAL

ANZ JOURNAL OF SURGERY, Issue 5 2005
Kate L. A. Borchard
Background: To review our 7 year experience of endovascular abdominal aortic aneurysm repair (EVR) and to compare this to open repair (OR) during the same time period. Methods: One hundred and one EVR and 65 OR patients were studied. Parameters analysed included patient and procedure details, intensive care unit (ICU) and hospital admission time, and morbidity and mortality with particular emphasis on procedure-related problems. Results: Endovascular grafts were deployed with successful abdominal aortic aneurysm (AAA) exclusion in 100 patients. Primary technical success was achieved in 84%, clinical success in 86% and secondary success in 90% of cases. Complications occurred in 63% and 88% of EVR and OR patients, respectively. Early device-related complications occurred in 40 EVR patients (40%); 24 (60%) were corrected immediately by further stenting. Late device-related complications occurred in 15 EVR patients (15%); four (27%) required additional stenting. Most of the complications in the OR group were systemic (89%) resulting in longer ICU and hospital stays (median 48 vs 17 h and 13 vs 4 days for OR and EVR, respectively). Death within 30 days of the procedure occurred in three EVR patients. There was no perioperative mortality in the OR group. Conclusion: Endovascular AAA repair can be undertaken successfully in a district general hospital. The majority of local and device-related complications can be corrected immediately, while those persisting beyond the initial procedure usually resolve spontaneously. EVR offers a minimally invasive approach to a problem that in the past has involved major surgery. [source]

Long-term outcome of endovascular abdominal aortic aneurysm repair

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2009
J. R. Boyle
Renal function is a concern [source]

Modelling the long-term cost-effectiveness of endovascular or open repair for abdominal aortic aneurysm,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2008
D. M. Epstein
Background: Recent randomized trials have shown that endovascular abdominal aortic aneurysm repair (EVAR) has a 3 per cent aneurysm-related survival benefit in patients fit for open surgery, but it also has uncertain long-term outcomes and higher costs. This study assessed the cost-effectiveness of EVAR. Methods: A decision model was constructed to estimate the lifetime costs and quality-adjusted life years (QALYs) with EVAR and open repair in men aged 74 years. The model includes the risks of death from aneurysm, other cardiovascular and non-cardiovascular causes, secondary reinterventions and non-fatal cardiovascular events. Data were taken largely from the EVAR trial 1 and supplemented from other sources. Results: Under the base-case (primary) assumptions, EVAR cost £3800 (95 per cent confidence interval (c.i.) £2400 to £5200) more per patient than open repair but produced fewer lifetime QALYs (mean , 0·020 (95 per cent c.i. , 0·189 to 0·165)). These results were sensitive to alternative model assumptions. Conclusion: EVAR is unlikely to be cost-effective on the basis of existing devices, costs and evidence, but there remains considerable uncertainty. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Letter: Mid-term results of endovascular repair of abdominal aortic aneurysm (Br J Surg 2005; 92: 925-927); Cost-effectiveness of endovascular abdominal aortic aneurysm repair (Br J Surg 2005; 92: 960-967)

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2006
H. D. I. De'Ath
The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses can be sent electronically via the BJS website (http://www.bjs.co.uk) or by post. All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Letters submitted by post should be typed on A4-sized paper in double spacing and should be accompanied by a disk. [source]

Authors' reply: cost-effectiveness of endovascular abdominal aortic aneurysm repair (Br J Surg 2005; 92: 960-967)

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2006
J. A. Michaels
No abstract is available for this article. [source]