Clinical outcomes of infrarenal abdominal aortic aneurysms that underwent endovascular repair in a district general hospital

Lee, Chih-Hsien; Chang, Chien Jung; Huang, Jau Kang; Yang, Ten-Fang

doi:10.21037/jtd.2016.06.30

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Our mean procedure time was 137 minutes, which is comparable to infrarenal standard EVAR, showing that using IVUS imaging does not increase the time of the procedure. 24 This is a feasibility study and if these preliminary results are confirmed by other studies, IVUS technology development could improve vascular navigation by coupling better imaging with accurate haemodynamic information about the aorta and its branches.…”

Section: Discussionmentioning

confidence: 60%

Endovascular Aneurysm Repair Using Anaconda Repositionable Aortic Stent Graft Assisted Exclusively by Intravascular Ultrasound Imaging

Barbera

Rosa

Valentino

et al. 2019

Vascular and Endovascular Review

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Arteriography with contrast medium (CM) injection is normally employed to visualise the lowest renal artery during endovascular aneurysm repair (EVAR). Intravascular ultrasound (IVUS) has been proposed as an alternative, real-time imaging diagnostic technique to arteriography. In this study, we evaluated the feasibility of EVAR using Anaconda repositionable aortic stent graft (Vascutek) assisted by IVUS (Volcano Visions, Philips) during intraluminal navigation without CM. From January 2016 to December 2017, 25 patients with infrarenal abdominal aortic aneurysms, identified through anatomical inclusion criteria, underwent EVAR. All of the patients had an arteriogram at the end of the EVAR procedure to confirm aortic stent graft patency and to exclude type 1 endoleaks. The primary objective was the technical and clinical success of this CM-free aortic stent graft delivery procedure. At the end of the period, 150 target vessels were evaluated. IVUS versus angio-CT sensitivity and specificity rate were 97.3% and 100%, respectively. The primary technical success was obtained in 88% of the cases. Three patients (12%) needed CM injection to complete the procedure and there were no cases of type 1 endoleak. Primary clinical success was 100%. During follow-up at a mean of 20 months, none of the patients died or had complications. We conclude that a full EVAR procedure is feasible using only IVUS navigation and repositionable aortic stent graft without CM injection in anatomically selected cases.

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Section: Discussionmentioning

confidence: 60%

Endovascular Aneurysm Repair Using Anaconda Repositionable Aortic Stent Graft Assisted Exclusively by Intravascular Ultrasound Imaging

Barbera

Rosa

Valentino

et al. 2019

Vascular and Endovascular Review

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show abstract

“…Despite the fact that the unavailability of vascular surgery team and intensive care facilities make transfer of RAAA patients inevitable, some investigators report encouraging results of RAAA management at district general hospitals. 14 It seems that the best place for the management of RAAA is the index hospital provided that the surgical team are proficient enough to manage the patients. This strategy may shorten the time from diagnosis to surgery and improve the outcomes.…”

Section: Discussionmentioning

confidence: 99%

In-hospital outcomes of ruptured abdominal aortic aneurysms: A single center experience

Tadayon

Mozafar

Zarrintan

2022

J Cardiovasc Thorac Res

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Introduction: Ruptured abdominal aortic aneurysm (RAAA) is a catastrophic condition with in-hospital mortalities up to 89%. Patient survival depends on multiple factors; however, prompt surgery is essential to prevent mortality. We report the in-hospital outcomes of RAAA at a high-volume and teaching vascular surgery center in Iran. Methods: This study is a single-center retrospective analysis of patients with infrarenal RAAA during February 20, 2012 to December 21, 2019 at Shohada-Tajrish Medical Center, Tehran,Iran. We identified 66 patients with RAAA during the study period. The patients were dividedinto two groups based on their transfer status (Transfer group versus non-transfer group). The primary outcome was in-hospital death. The secondary outcomes were in-hospital myocardial infarction (MI), abdominal compartment syndrome (ACS) and postoperative renal dysfunction requiring dialysis. Results: The mean age of the patients was 74.2 ± 8.3 years. Forty-seven patients (71.2%) were transferred to our center from other institutions. There were 46 in-hospital deaths (69.7%) and three in-hospital MIs (4.5%). Three patients (4.5%) had postoperative ACS and six patients (9.1%)had postoperative renal dysfunction requiring dialysis. Transfer patients had an increased rate of in-hospital death compared to non-transferred patients (76.6.1% versus 52.6%); however, the difference was not statistically significant (P=0.055). Conclusion: We found no significant different between operative mortality of transferred and non-transferred RAAA patients. Transfer of patients to tertiary centers with experienced vascular surgeons may delay the surgery. However, the transfer may be inevitable in areas where the optimal care of RAAA patients is not possible.

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“… 1 , 2 EVAR is a common treatment for AAA, and approximately 70% of patients in America undergo this procedure to treat AAA. 3 Since the National Health Insurance began to cover endovascular grafts in 2010 in Taiwan, most patients have elected to undergo EVAR to treat AAA, 4 and even patients with a ruptured AAA are attempting to undergo EVAR. 5 …”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in patients with abdominal aortic aneurysm undergoing endovascular aneurysm repair: A cross-sectional study

Shih

et al. 2020

Journal of the Chinese Medical Association

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Background: Endovascular aneurysm repair (EVAR) has become a common surgical treatment for abdominal aortic aneurysm (AAA), and postoperative health-related quality of life (HRQoL) is drawing increasing attention. Most studies compare HRQoL in EVAR patients and open aneurysm repair patients, while few studies have investigated HRQoL in EVAR patients versus the general population. This study aimed to investigate whether HRQoL differs between patients with EVAR patients and the general population. Methods: EVAR patients were recruited from a medical center in northern Taiwan. General population subjects and the EVAR patients were paired based on age and sex, and a simple random sampling method was used for sampling at 2:1. In this study, we used the World Health Organization Quality of Life Scale Abbreviated Version, Taiwan Version to investigate HRQoL. A multivariate regression model was used to analyze intergroup differences related to facets and domains. Results: A total of 58 patients with EVAR and 116 individuals from the general population were included in this study. The EVAR patients’ mean scores for overall QoL and the physical domain, psychological domain, social relations domain, and environment domain were 3.79, 15.53, 15.00, 14.93, and 15.57, respectively, and all of these scores were significantly higher than those in the general population. In addition, the β values (β = 0.21, 0.73, 1.83, 0.81, and 2.62, respectively) of the EVAR patients were also significantly higher in the multivariate analysis. The findings showed that a high education level and nonsmoking status were associated with higher HRQoL, while unemployment was associated with lower HRQoL. Conclusion: EVAR patients had higher HRQoL than the general population, indicating that patients with AAA have a high likelihood of recovering and enjoying high HRQoL if they receive appropriate medical procedures and nursing education.

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Clinical outcomes of infrarenal abdominal aortic aneurysms that underwent endovascular repair in a district general hospital

Cited by 4 publications

References 21 publications

Endovascular Aneurysm Repair Using Anaconda Repositionable Aortic Stent Graft Assisted Exclusively by Intravascular Ultrasound Imaging

Endovascular Aneurysm Repair Using Anaconda Repositionable Aortic Stent Graft Assisted Exclusively by Intravascular Ultrasound Imaging

In-hospital outcomes of ruptured abdominal aortic aneurysms: A single center experience

Health-related quality of life in patients with abdominal aortic aneurysm undergoing endovascular aneurysm repair: A cross-sectional study

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