Population-based long-term outcomes of open versus endovascular aortic repair of ruptured abdominal aortic aneurysms
Existing data regarding endovascular aortic repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA) are conflicting in their findings. The purpose of this paper was to determine the long-term outcomes of EVAR vs open surgical repair (OSR) for treatment of rAAA.
Popliteal artery aneurysm (PAA) carries a risk of sudden thromboembolism resulting in acute limb ischaemia (ALI). Since 2010, all 65 years old men in Region Sk åne are invited for abdominal aortic aneurysm (AAA) screening, and subsequently for PAA if AAA is detected.
The present study evaluates aneurysmal sac remodeling and the loss of intercostal arteries after the first step of staged treatment of thoraco-abdominal aortic aneurysms (TAAA). The purpose of this approach is to keep the aneurysmal sac temporarily perfused in order to induce progressive thrombosis of the aneurysm while simultaneously allowing the spinal cord to establish adequate perfusion thereby promoting the development of collateral circulation.
Endovascular aortic aneurysm repair (EVAR) is associated with the risk of late complications and mandates follow up. This retrospective study assessed post-EVAR complications in a two centre cohort. The study evaluated the rate of complications presenting with symptoms vs. those detected by imaging follow up. Additionally, the agreement between DUS and CTA in detecting complications was assessed in patients with both.
CONCLUSION: Approximately a quarter of the patients developed complications, the majority of which were asymptomatic, underlining the importance of adequate surveillance. There was good agreement between CTA and DUS in detecting complications. Clinically significant complications related to inadequate seal were missed by DUS, suggesting that CTA still plays an important role in EVAR surveillance. PMID: 32209282 [PubMed - as supplied by publisher]
The aim was to assess peri-operative mortality of endovascular aneurysm repair (EVAR) vs. open repair for ruptured abdominal aortic aneurysm (AAA) and to investigate whether outcomes have improved over the years and whether there is an association between institutional caseload and peri-operative mortality.
The objective was to investigate whether endovascular aneurysm repair (EVAR) has better peri-operative and late clinical outcomes than open repair for non-ruptured abdominal aortic aneurysm.
Almost since inception, endovascular aneurysm repair (EVAR) was felt to be a less invasive way to treat abdominal aortic aneurysm in higher risk patients, many of whom would not be candidates for open repair. Graft manufacturers are required to submit instructions for use (IFU) as part of the approval process. Physicians are not required to follow the IFU, but it makes sense to adhere to it as much as feasible to allow maximal benefit to the patient. The meta-analysis by Antoniou et al1 looks at 4500 patients treated with EVAR between 2006 and 2015.
Rocha et al1 present the most comprehensive—to date—comparative analysis on outcomes after open vs endovascular repair for thoracoabdominal aortic aneurysms (TAAAs). Their analysis is as thorough as it is thoughtful and candid. An important finding of this study relates to the realization that the risk of postoperative complications is high regardless of treatment strategy. Mortality was similar for both treatment modalities, and although one could argue that sicker patients were preferentially treated with endovascular means, clearly the three- to five-fold improvement in early postoperative mor tality t...
Large aneurysm diameter represents a well known predictor of late complications after endovascular aneurysm repair (EVAR). However, the role of the thrombus free lumen inside the abdominal aortic aneurysm (AAA) sac is not clear. It was hypothesised that greater luminal volume represents a relevant risk factor for late complications after EVAR.
es FB Abstract OBJECTIVE: Large aneurysm diameter represents a well known predictor of late complications after endovascular aneurysm repair (EVAR). However, the role of the thrombus free lumen inside the abdominal aortic aneurysm (AAA) sac is not clear. It was hypothesised that greater luminal volume represents a relevant risk factor for late complications after EVAR. METHODS: A retrospective cohort analysis was performed including all patients undergoing EVAR from 2005 to 2016 at a tertiary referral institution. Pre-operative AAA lumen volume was measured in centre lumen line reconstructions and patien...