Anatomical Features and Early Outcomes of Endovascular Repair of Abdominal Aortic Aneurysm from a Korean Multicenter Registry

Kwon, Hyuksool; Lee, Do Yun; Choi, Soo Jin Na; Park, Ki Hyuk; Min, Seung-Kee; Chang, Jeong-Hwan; Huh, Seung; Jeon, Yong Sun; Won, Jong Uk; Byun, Seung Jae; Park, Sang Jun; Jang, Lee-Chan; Kwon, Tae-Won

doi:10.5758/vsi.2015.31.3.87

Cited by 9 publications

(9 citation statements)

References 29 publications

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“…Few studies have reported the suitability for EVAR among Korean patients. One study from a Korean multicenter registry reported that the mean suprarenal and infrarenal angulations were 33.9° and 46.8°, respectively, and the mean aortic neck length was 35.0 mm [ 9 ]; however, this study only included patients undergoing EVAR. Another study demonstrated that the suitability of aortic neck anatomy in Korean patients was 63%, the mean length was 28.0 mm, and the mean infrarenal angulation was 47.5° in 192 patients [ 10 ]; however, this study included AAAs more than 4 cm in maximal diameter, so did not represent typical patients requiring treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Several factors, such as ethnicity and sex, are known to be associated with suitability for EVAR, with a lower percentage among Asians and women [ 7 , 8 ]. Although there have been a few reports regarding the aortoiliac anatomy of AAAs in Asian patients, the results have been inconsistent because of the small number of patients and the different inclusion criteria for analysis [ 7 , 9 - 11 ]. Therefore, further work is necessary to investigate the aortoiliac anatomy in Asians, and determine whether there are significant differences between different Asian populations, as well as between Asian and Western patients.…”

Section: Introductionmentioning

confidence: 99%

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Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm

Hwang

Kim

et al. 2020

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Purpose To evaluate the aortic neck anatomy in Korean patients with abdominal aortic aneurysms (AAAs). Materials and Methods We examined computed tomography scans of 343 patients with AAAs (≥5.5 cm for men or ≥5 cm for women) between 2009 and 2018. Eligibility of neck anatomy for endovascular aneurysm repair (EVAR) was assessed with the standard instructions for use (IFU) (length ≥15 mm, suprarenal angulation (SRA) ≤45°, infrarenal angulation (IRA) ≤60°, and diameter 18-32 mm) and the extended IFU (length ≥10 mm, SRA ≤60°, IRA ≤75°, and diameter 17-32 mm). Results There were 71 women (20.7%), and 61 patients (17.8%) with rupture. Women had smaller neck diameters (21.3 vs. 23.4 mm, P<0.001 for proximal neck; 22.2 vs. 24.5 mm, P<0.001 for distal neck), and higher angulations (51.5° vs. 37.8°, P<0.001 for SRA; 77.7° vs. 57.0°, P<0.001 for IRA) than men. However, the neck length was not significantly different. Patients with ruptured AAAs had shorter neck lengths (21.0 vs. 26.8 mm, P=0.005) than those with intact AAAs. However, the neck diameters and angulations were not significantly different. EVAR eligibility for standard and extended IFUs was found in 37.5% and 55.1% of men, and 11.3% and 25.4% of women (P<0.001 for both IFUs); neck anatomy was eligible in 34.0% of intact AAAs and 23.0% of ruptured AAAs (P=0.098). Conclusion A significant proportion of the Korean patients did not meet the IFU for EVAR, mainly due to the angulated neck. Women, and patients with ruptured AAAs, were less likely to meet the IFU criteria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm

Hwang

Kim

et al. 2020

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“…Coronary artery disease was defined as a history of myocardial infarction or angina, percutaneous coronary intervention, coronary artery bypass grafting, and/or ischemic ST segment abnormalities on preoperative electrocardiography [13]. Patient with a serum creatinine level > 1.7 mg/dL were considered to have decreased renal function [14]. …”

Section: Methodsmentioning

confidence: 99%

Analysis of in hospital mortality and long-term survival excluding in hospital mortality after open surgical repair of ruptured abdominal aortic aneurysm

et al. 2016

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PurposeThe aim of this study was to confirm the factors that affect the mortality associated with the open surgical repair of ruptured abdominal aortic aneurysm (rAAA) and to analyze the long-term survival rates.MethodsA retrospective review was performed on a prospectively collected database that included 455 consecutive patients who underwent open surgical repair for AAA between January 2001 and December 2012. We divided our analysis into in-hospital and postdischarge periods and analyzed the risk factors that affected the long-term survival of rAAA patients.ResultsOf the 455 patients who were initially screened, 103 were rAAA patients, and 352 were non-rAAA (nAAA) patients. In the rAAA group, 25 patients (24.2%) died in the hospital and 78 were discharged. Long-term survival was significantly better in the nAAA group (P = 0.001). The 2-, 5-, and 10-year survival rates of the rAAA patients were 87%, 73.4%, and 54.1%, respectively. Age (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.02–.08; P < 0.001) and aneurysm rupture (HR, 1.96; 95% CI, 1.12–.44; P = 0.01) significantly affected long-term survival.ConclusionPreoperative circulatory failure is the most common cause of death for in-hospital mortality of rAAA patients. After excluding patients who have died during the perioperative period, age is the only factor that affects the survival of rAAA patients.

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“…Em 1991 a primeira endoprótese bifurcada foi implantada com sucesso e o FDA -Food and Drug Administration -aprovou as duas primeiras endopróteses para uso disseminado. Desde então, tem havido avanços progressivos no design desses dispositivos, permitindo o tratamento de casos cada vez mais complexos anatomicamente 49,53,55,56 .…”

Section: O Período Moderno Da Cirurgia De Aneurismas Começou Em 1817 ...unclassified

“…Em torno de 17% a 40% dos doentes com AAA apresentam aneurisma de artéria ilíaca 55,69,[95][96][97] . Dentre os aneurismas de ilíaca, 70% ocorrem na ilíaca comum, 20% na interna e 10% na externa e até um terço dos AAI são bilaterais.…”

Section: Diâmetro Aorto -Ilíaco E Anatomiaunclassified

Avaliação da influência da anatomia dos aneurismas de aorta abdominal infra-renal nos eventos intra-operatórios e nos desfechos clínicos no pós-operatório na Unidade de Terapia Intensiva após cirurgia endovascular

Leslie Albanez de Souza Siqueira

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sua dedicação em contribuir com meu crescimento pessoal e profissional e por me incentivar e apoiar na condução dessa pesquisa e na minha formação como médica e cirurgiã vascular.Ao meu coorientador, Professor Doutor Antônio Luís Eiras Falcão, pela dedicação e cuidado aos doentes que passam pela Unidade de Terapia Intensiva do HC-UNICAMP e pela dedicação e confiança que depositou em mim, sendo fundamental na realização dessa pesquisa.Ao meu esposo, Daniel Emilio Dalledone Siqueira, por todo cuidado e dedicação em me conduzir no caminho de buscar ser sempre melhor.À minha mãe, Suely e à minha irmã, Nathasha, por serem sempre meu porto seguro durante toda a vida, e, especialmente, durante toda a minha formação.Ao meu pai, Almir (in memorian) que despertou em mim o amor pelo estudo e pela medicina.Ao amigo Dr. Alex Aparecido Cantador, pela grande ajuda e incentivo durante a realização deste trabalho e por todos os anos de convívio e amizade.Aos docentes e assistentes da Disciplina de Moléstias Vasculares, pela dedicação à formação de seus residentes.Aos ex-residentes e amigos da Disciplina de Moléstias Vasculares pelo convívio, aprendizado e amizade. Aos professores, funcionários, alunos e colegas da Pós-graduação em ciências da cirurgia, pelos ensinamentos e incentivo à pesquisa.À Universidade Estadual de Campinas -UNICAMP e FCM, por ter me dado a oportunidade de realizar toda minha formação e por deixar ao alcance da população a chance de receber tratamentos de excelência.Aos doentes do Hospital de Clínicas da UNICAMP, por nos permitir o imenso aprendizado e a lapidar nossa vocação a cada dia, nos ensinando grandes lições de humildade.Ao Gabriel Franco e Júlia Barreira pelo trabalho realizado na bioestatística.À Léia Rachel Castellar, pela editoração.A todos que direta ou indiretamente contribuíram na elaboração e conclusão desse trabalho. RESUMOObjetivos: Avaliar a influência de características anatômicas do eixo aorto-ilíaco de doentes submetidos a correção endovascular de aneurisma de aorta abdominal infrarrenal nos desfechos intra-operatórios e pós-operatórios no ambiente de terapia intensiva. Métodos: Estudo retrospectivo, realizado entre janeiro de 2013 e dezembro de 2017 com 125 doentes submetidos a correção eletiva endovascular de aneurismas de aorta abdominal infrarrenal, em um centro único de referência em cirurgia endovascular. Após análise das angiotomografias, os doentes foram divididos de acordo com características anatômicas do eixo aorto-ilíaco em 4 grupos: grupos I e II (colo favorável, sem e com aneurisma de ilíaca, respectivamente) e grupos III e IV (colo hostil, sem e com aneurisma de ilíaca, respectivamente). Foram compilados dados intra e pós-operatórios durante a permanência na Unidade de Terapia Intensiva. Foram confrontados os dados anatômicos e clínicos e correlacionados com os desfechos clínicos na UTI e com a morbimortalidade. Resultados: todos os doentes foram submetidos à correção eletiva dos AAA infrarrenais, sendo 18% fora das instruções de uso das endopróteses comercialmente dispon...

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Anatomical Features and Early Outcomes of Endovascular Repair of Abdominal Aortic Aneurysm from a Korean Multicenter Registry

Cited by 9 publications

References 29 publications

Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm

Suitability of the Aortic Neck Anatomy for Endovascular Aneurysm Repair in Korean Patients with Abdominal Aortic Aneurysm

Analysis of in hospital mortality and long-term survival excluding in hospital mortality after open surgical repair of ruptured abdominal aortic aneurysm

Avaliação da influência da anatomia dos aneurismas de aorta abdominal infra-renal nos eventos intra-operatórios e nos desfechos clínicos no pós-operatório na Unidade de Terapia Intensiva após cirurgia endovascular

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