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Endovascular Aneurysm Repair (endovascular + aneurysm_repair)
Selected AbstractsEndovascular aneurysm repair independently demonstrates a volume-outcome effectBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue S1 2009P. J. E. Holt No abstract is available for this article. [source] Review of Interventional Repair for Abdominal Aortic AneurysmJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2006F.A.C.C., F.A.C.P., F.A.S.A., MAJED CHANE M.D. Abdominal aortic aneurysm is associated with high mortality rate. For over 50 years, open surgical repair was the standard approach for large aneurysms. However, over the past decade, endovascular aneurysm repair (EVAR) has emerged as a viable alternative. EVAR is associated with lower operative and short-term morbidity and mortality and similar long-term survival (up to 4 years) compared with surgical repair. Endoleak remains a significant limitation associated with aneurysm expansion and reintervention. With newer, more versatile endograft designs, improvements in durability, and better surveillance techniques, the utilization of EVAR is likely to continue to expand. [source] Acute kidney injury following elective endovascular aneurysm repairANAESTHESIA, Issue 2 2010P. S. Lancaster No abstract is available for this article. [source] Use of baseline factors to predict complications and reinterventions after endovascular repair of abdominal aortic aneurysm,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2010L. C. Brown Background: It is uncertain which baseline factors are associated with graft-related complications and reinterventions after endovascular aneurysm repair (EVAR) in patients with a large abdominal aortic aneurysm. Methods: Patients randomized to elective EVAR in EVAR Trial 1 or 2 were followed for serious graft-related complications (type 2 endoleaks excluded) and reinterventions. Cox regression analysis was used to investigate whether any prespecified baseline factors were associated with time to first serious complication or reintervention. Results: A total of 756 patients who had elective EVAR were followed for a mean of 3·7 years, by which time there were 179 serious graft complications (rate 6·5 per 100 person years) and 114 reinterventions (rate 3·8 per 100 person years). The highest rate was during the first 6 months, with an apparent increase again after 2 years. Multivariable analysis indicated that graft-related complications increased significantly with larger initial aneurysm diameter (P < 0·001) and older age (P = 0·040). There was also evidence that patients with larger common iliac diameters experienced higher complication rates (P = 0·011). Conclusion: Graft-related complication and reintervention rates were common after EVAR in patients with a large aneurysm. Younger patients and those with aneurysms closer to the 5·5-cm threshold for intervention experienced lower rates. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Long-term surveillance with computed tomography after endovascular aneurysm repair may not be justified,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2009Mr S. A. Black Background: There is a common perception that a large number of secondary interventions are needed following endovascular aortic aneurysm repair. Methods: Prospective data were collected for a cohort of 417 consecutive elective patients undergoing infrarenal aortic endograft repair between April 2000 and May 2008. The rate of secondary interventions, associated morbidity and need for reintervention following surveillance imaging were analysed. Results: The male : female ratio was 11 : 1, median age 76 (range 40,93) years and median aneurysm diameter 6·1 (5·3,11) cm. The overall 30-day mortality rate was 1·7 per cent (seven of 417). Secondary interventions were performed in 31 patients (7·4 per cent), of which six (1·4 per cent) were detected by surveillance. Endoleaks requiring reintervention occurred in 12 patients (2·9 per cent; ten type I and two type III endoleaks). Limb ischaemia secondary to graft occlusion occurred in 17 patients (4·1 per cent); extra-anatomical bypass was needed in 15 patients (3·6 per cent) and the remaining two had an amputation. Graft explantation following late infection was required in two patients (0·5 per cent). Conclusion: Endoluminal repair of infrarenal aortic aneurysms can be performed with a low reintervention rate. The value of prolonged surveillance seems limited and current surveillance protocols may require revision. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Impact of renal dysfunction on operative mortality following endovascular abdominal aortic aneurysm surgery,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2007R. G. Statius van Eps Background: Preoperative renal dysfunction is a significant risk factor for death after open abdominal aortic aneurysm repair. The aim of this study was to determine whether renal dysfunction also affected mortality after endovascular aneurysm repair. Methods: Patients from the EUROSTAR registry were stratified into two groups: 4198 with normal renal function (creatinine less than 133 µmol/ml) and 969 with renal dysfunction (serum creatinine more than 133 µmol/ml). Patient characteristics and postoperative complications in the two groups were compared and the effect of renal dysfunction on operative mortality was analysed by multivariable regression models. Results: Patients with renal dysfunction had significantly more co-morbidities, including cardiac and pulmonary impairment. Thirty-day mortality was significantly higher in the group with renal dysfunction (6·2 versus 2·0 per cent; P < 0·001). A significant increase in mortality (5·5 per cent) was also seen in patients with moderate renal dysfunction (serum creatinine 133,265 µmol/ml). After adjustment for age and other risk factors, renal dysfunction was still an independent risk factor for 30-day mortality (odds ratio 2·3, 95 per cent confidence interval 1·6 to 3·3; P < 0·001). Conclusion: Renal dysfunction was a significant and independent risk factor for death after endovascular aneurysm repair. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Suitability for endovascular aneurysm repair in an unselected population (Br J Surg 2001; 88: 77,81)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2001M. P. Armon No abstract is available for this article. [source] Aneurysm-related mortality during late follow-up after endovascular aneurysm repair of infrarenal aortaBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2001S. R. Vallabhaneni Background: Aneurysm-related mortality (ARM) accounts for around 1·5 per cent of all deaths following open aneurysm repair. The incidence of ARM following endovascular aneurysm repair (EVAR) is unknown. The aim was to examine all causes of death, including ARM, during late follow-up after EVAR. ARM was defined as death resulting directly from rupture of the repaired aneurysm or another complication of the aneurysm, more than 30 days after repair, or death within 30 days of a secondary intervention undertaken solely to rectify a complication of repair. Methods: Preoperative and follow-up data on 2194 patients from 88 European centres were collected prospectively on to a database. Survival up to 48 months after EVAR was analysed by means of Kaplan,Meier survival analysis. The causes of death during this period were noted. Results: There were 161 deaths between 1 and 48 months after EVAR. The cumulative rate of secondary intervention for this cohort at 4 years was 33 per cent. The causes of death were: cardiac 28·6 per cent, malignancy 18·6 per cent, cerebrovascular 6·8 per cent, respiratory 3·1 per cent, renal 1·8 per cent, other 22·3 per cent and ARM 11·8 per cent. There were 19 deaths from aneurysm-related causes. Nine patients died following proven rupture of the aneurysm, three died from presumed rupture of the aneurysm and a further seven died following late conversion (three patients), graft sepsis (two) and secondary intervention (two). Sudden death of uncertain cause occurred in ten patients in whom rupture of AAA was a possibility. Conclusion: Non-aneurysm-related causes of death were comparable to those in published reports of survival after open repair. However, the proportion of aneurysm-related deaths (11·8 per cent) was appreciably higher than that reported after open repair. These results may reflect the learning curve experience of the teams involved in the study, but continued caution is advisable regarding expectations of outcome following EVAR. © 2001 British Journal of Surgery Society Ltd [source] | ||||||||||