No Differences in Perioperative Outcome between Symptomatic and Asymptomatic AAAs after EVAR: An Analysis from the ENGAGE Registry

Stokmans, R.A.; Teijink, Joep A.W.; Cuypers, Philippe W.M.; Riambau, Vincent; Sambeek, Marc R.H.M. van

doi:10.1016/j.ejvs.2012.02.034

Cited by 17 publications

(13 citation statements)

References 26 publications

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“…29,30 When EVAR was performed in symptomatic but unruptured patients as a result of elective aneurysms and surgery was compared, there was no difference in the 30-day mortality. 31 In our study, 30-day mortality was 42.3% for group I and 44.4% for group II and 1-year mortality was 7.7% 5.6%, respectively. Although the general condition of applied patients was often bad, our mortality rates are compatible with the literature.…”

Section: Discussionsupporting

confidence: 46%

Ruptured Abdominal Aortic Aneurysm Treatment in the Stent Graft Era

Tulga

Küçükay

Simsek

et al. 2014

Vasc Endovascular Surg

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Section: Discussionsupporting

confidence: 46%

Ruptured Abdominal Aortic Aneurysm Treatment in the Stent Graft Era

Tulga

Küçükay

Simsek

et al. 2014

Vasc Endovascular Surg

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“…Subsequent to the VSGNE study, the ENGAGE registry for Endurant post-market surveillance reported similar 30-day mortality in 185 symptomatic AAAs compared to 1015 asymptomatic AAAs (0.5% vs. 1.5% respectively, p=.31). [9] However, it is difficult to compare real-world results from the NSQIP to a post-marketing surveillance study where most patients met strict eligibility criteria and received the same endograft. Our 30-day mortality rate for patients with asymptomatic aneurysms undergoing EVAR or open repair were consistent with rates previously reported for the NSQIP.…”

Section: Discussionmentioning

confidence: 99%

“…[7–9, 23] The reason for this remains unclear from this analysis; however, our previous work has shown that women are being repaired at relatively larger aneurysm sizes when diameter is indexed to body size. [24] Patients presenting with symptomatic or ruptured AAA were also more likely to be non-white.…”

Section: Discussionmentioning

confidence: 99%

Outcomes for symptomatic abdominal aortic aneurysms in the American College of Surgeons National Surgical Quality Improvement Program

Soden

Zettervall

Ultee

et al. 2016

Journal of Vascular Surgery

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Introduction-Historically symptomatic AAAs were found to have intermediate mortality compared to asymptomatic and ruptured AAAs but, with wider EVAR use, a more recent study suggested mortality of symptomatic aneurysms were similar to asymptomatic AAAs. These prior studies were limited by small numbers. The purpose of this study is to evaluate the mortality and morbidity associated with symptomatic AAA repair in a large contemporary population.

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“…18,19 The Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE) is a global, prospective multicentre registry evaluating the Endurant stent graft system (Medtronic, Santa Rosa, CA, USA) and is the largest registry for any single EVAR stent graft. 20 Stokmans et al published the peri-operative, 30 day, and interim one year results, 21 as well as a comparison between symptomatic and asymptomatic AAAs, 22 from the ENGAGE registry. Other analyses of the ENGAGE registry have investigated outcomes for octogenarians, differences due to sex, and higher risk anatomies and conditions.…”

Section: Introductionmentioning

confidence: 99%

Editor's Choice – Five Year Outcomes of the Endurant Stent Graft for Endovascular Abdominal Aortic Aneurysm Repair in the ENGAGE Registry

Teijink

Power

Böckler

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS Analysis of the performance of modern stent grafts is necessary as earlier generation stent grafts are associated with an increased need for secondary interventions. Five year follow up of patients treated with the Endurant stent graft in the ENGAGE registry demonstrates better survival and lower rates of endoleaks, stent migration, and re-intervention. Longer term follow up to 10 years will be necessary to compare fully the advantages of endovascular aneurysm repair against open repair. However, these mid-term results show the Endurant stent graft was successful in treating a large cohort of patients with a wide range of anatomies. Objective/background: Endovascular abdominal aortic aneurysm repair (EVAR) is commonly used to treat abdominal aortic aneurysm (AAA). However, the incidence of long-term complications and the need for reinterventions after EVAR remain a concern. Newer generation stent grafts have encouraging short and midterm outcomes, but thorough analysis of their long-term performance is necessary. Methods: The ENGAGE registry includes a total of 1263 patients with AAA enrolled from March 2009 to April 2011 at 79 centres across 30 countries. The aim of this study is to present standard EVAR outcomes in the registry after five years. Results: A significant proportion of the ENGAGE patients presented with challenging features, such as 15.2% with an AAA diameter >7 cm, 12.0% with proximal neck lengths <15 mm, and 10.2% with infrarenal neck angles >60. Of the 1263 enrolled subjects, 17.8% were implanted outside of the instructions for use for the device. At the five year follow up, the KaplaneMeier overall survival rate was 67.4% and the freedom from aneurysm related mortality was 97.8%. Freedom from aneurysm rupture, secondary procedures, and conversion to open repair at five years were 98.6%, 84.3%, and 97.9% respectively. The five year freedom from type IA endoleaks was 95.2% and for type III endoleaks 97.4%. Aneurysm sac diameter at five years was observed to have either decreased !5 mm in diameter or remained stable in 89.4% of the patients. Conclusion: Five year follow up of patients in the ENGAGE registry demonstrates sustained safety, effectiveness, and durability in an international cohort that is reflective of real world experience. Additional follow up is expected through to 10 years.

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No Differences in Perioperative Outcome between Symptomatic and Asymptomatic AAAs after EVAR: An Analysis from the ENGAGE Registry

Abstract: With contemporary devices and technical proficiency, there is no difference in outcome between symptomatic AAA and elective non-symptomatic AAA patients if treated with endovascular techniques.

Cited by 17 publications

References 26 publications

Ruptured Abdominal Aortic Aneurysm Treatment in the Stent Graft Era

Ruptured Abdominal Aortic Aneurysm Treatment in the Stent Graft Era

Outcomes for symptomatic abdominal aortic aneurysms in the American College of Surgeons National Surgical Quality Improvement Program

Editor's Choice – Five Year Outcomes of the Endurant Stent Graft for Endovascular Abdominal Aortic Aneurysm Repair in the ENGAGE Registry

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