Volume Standards for Open AAA Repair Are Not Associated With Improved Clinical Outcomes
A retrospective review was conducted of Medicare beneficiaries>65 years of age between 2013 and 2014 with data from the Vascular Quality Initiative used to estimate total hospital annual volume of open abdominal aortic aneurysm (AAA) repair.
Infected aortic aneurysm is life-threatening if it is not treated properly, with high mortality rate when open repair is performed. The goal of treatment is to prevent rupture and to eliminate infection. The endovascular technique is accepted for bridging to definite repair. Our study compares the results of endovascular and conventional open repair for infected thoracic and abdominal aortic aneurysm.
The use of endovascular aneurysm repair (EVAR) in abdominal aortic aneurysm is limited by neck configuration and angulation. Using stent grafts outside the instructions for use may result in failure and higher endoleak rate. Treatment and prevention of endoleaks with additional use of uncovered stents in the neck have been reported in single cases and small series.
Many options of complex endovascular aneurysm repair (EVAR) can be used for treatment of juxtarenal, paravisceral, and thoracoabdominal aortic aneurysm, such as chimney, periscope, and sandwich techniques.1 Chimney EVAR (chEVAR) is an attractive option that can be done safely in urgent settings, but reintervention is unavoidable if aneurysm progression causes a type IA endoleak.2
The objective of this exposition was to compare our experience of both techniques.
The effects of intensive care unit (ICU) stay after elective open surgical repair (OSR) for abdominal aortic aneurysm (AAA) are not well known. Patients admitted to the ICU have more comorbidities, which can result in worse outcomes. We analyze long-term results of OSR at a single academic institution.
Proximal anastomotic leak and pseudoaneurysm are among the severe complications that follow open surgical repair (OSR) of abdominal aortic aneurysm (AAA), resulting in increased hospital stay and mortality. Degradative vascular wall of aneurysm neck and suture-associated split remain leading causes. Thereby, we propose a novel approach of “ring on anastomosis” (ROA), which reinforces the proximal anastomotic section, to evaluate its role in decreasing proximal anastomotic leak.
Synchronous cancer in patients with abdominal aortic aneurysm (AAA) increases their morbidity and mortality after AAA repair. However, little is known about the history of cancer in AAA patients and its impact on mortality after AAA repair. We analyzed the incidence and type of cancer history in patients who underwent AAA repair and difference in short- and long-term mortality.
The operative risk for treatment of abdominal aortic aneurysm (AAA) is reported to be higher in female patients than in male patients for open repair as well as for endovascular aneurysm repair (EVAR). In some regions, female patients are not considered candidates for treatment, but they are known to rupture with a four times higher incidence at the same aneurysm diameter as in men. The aim of this study was to evaluate operative results of standard EVAR in female patients with special focus on long-term results.
The objective of this report was to present our experience with transcatheter aortic valve replacement (TAVR) and endovascular aneurysm repair (EVAR) performed simultaneously in patients with severe aortic stenosis and abdominal aortic aneurysm meeting criteria for repair.
Aortic disease is among the top 20 leading causes of death in the United States. The open repair of abdominal aortic aneurysm was first described in 1952 and since then has been the “gold standard,” but with the newer endovascular procedures being less invasive, its use has decreased. In 2014, Dua et al1 raised concerns that the volume of open aneurysm repair procedures is no longer conducive to an adequate vascular trainee education and that by 2020, vascular trainees are expected to do half of the open aneurysm repair cases that were done in 2010.