Renal outcomes analysis after endovascular and open aortic aneurysm repair

Martin-Gonzalez, Térésa; Pinçon, Claire; Hertault, Adrien; Maurel, Blandine; Labbé, D; Spear, Rafaëlle; Sobocinski, Jonathan; Haulon, Stéphan

doi:10.1016/j.jvs.2015.03.075

Cited by 29 publications

(22 citation statements)

References 40 publications

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“…This again mirrors other reports for open and endovascular complex aneurysm repair. 31 A long-term assessment of renal function in this patient population is currently underway. SCI symptoms developed in 8% of patients overall, but the symptoms resolved in nearly half of the patients before discharge from the hospital.…”

Section: Discussionmentioning

confidence: 99%

Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms

Eagleton

Follansbee

Wolski

et al. 2016

Journal of Vascular Surgery

253

169

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F/B-EVAR is a robust treatment option for patients at increased risk for conventional repair of extensive TAAAs. Technical success and branch patency are excellent, but some patients will require reintervention for branch-related endoleak. Aneurysm extent portends a higher risk of perioperative and long-term morbidity and mortality. Additional efforts are needed to improve outcomes and understand the utility of this treatment option in the general TAAA population.

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Section: Discussionmentioning

confidence: 99%

Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms

Eagleton

Follansbee

Wolski

et al. 2016

Journal of Vascular Surgery

253

169

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“…36 In the setting of aneurysm repair, renal impairment has been associated with worsening renal function postoperatively, as well as increased operative and long term mortality for both open and endovascular repair. 30,31,[37][38][39] Renal artery stenosis and occlusive disease was associated with worsening renal function, but in the setting of F/B-EVAR the impact of this disease process is not fully understood and may potentially have a multifactorial effect, adversely influencing renal branches in combination with functional impairment.…”

Section: Discussionmentioning

confidence: 99%

Survival affects decision making for fenestrated and branched endovascular aortic repair

Beach

Rajeswaran

Parodi

et al. 2018

Journal of Vascular Surgery

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Patients with multiple comorbidities and those undergoing type I or II TAAA repair are at greatest risk of mortality; however, in this high-risk population, F/B-EVAR offers greater survival compared with that reported for the natural history of untreated aneurysms. Operative and early mortality is lower than the best-reported open repair outcomes, even in this high-risk population, suggesting a potential benefit in extending the use of F/B-EVAR to low-to-average risk CAA patients.

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“…2016 [13] a 2004–2013 n  = 354–Type II and III TAAA, elective f‑EVAR, b‑EVAR94.1% technical success, 4.8% mortality at 30 days(73.5 years, 76.3% males)Martin-Gonzales et al. 2015 [21]2004–2012 n  = 225Single centerType I–V TAAA, elective f‑EVAR, b‑EVAR95.5% technical success, 6.2% mortality at 30 days(70.5 years, 93.8% males)Mastracci et al. 2015 [22] a 2001–2013 n  = 610–Type IV TAAA ( n  = 349), juxtarenal ( n  = 258), unclassified ( n  = 3), f‑EVAR, b‑EVAR95–96% technical success, 2% aneurysm-related fatalities at 8 years(75 years, 82.1% males)Kristmundsson et al.…”

Section: Discussionmentioning

confidence: 99%

“…2016 [13] a –24.943.8–30.814.718.6Martin-Gonzales et al. 2015 [21]5.814.750.7 (CAD)79.142.220.923.635.6 (PAD)Mastracci et al. 2015 [22] a –27.9––31.119.5–Kristmundsson et al.…”

Section: Discussionmentioning

confidence: 99%

Complex endovascular treatment of intact aortic aneurysms

et al. 2018

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BackgroundThe complex endovascular repair of aortic aneurysms and dissections with fenestrated or branched stent grafts (FB-EVAR) remains challenging for interventional vascular surgery. To date, the evidence regarding treatment patterns and outcome measures consists of single center studies; however, it might be reasonable to validate results with multicenter real-world evidence.MethodsHealth insurance claims data from Germany’s third largest insurance provider, DAK-Gesundheit, were used to determine outcomes following FB-EVAR of non-ruptured thoracic aorta (TA) or thoracoabdominal including pararenal abdominal (TAA) aorta. The study included patients operated between January 2008 and April 2017.ResultsIncluded were 984 patients (18.1% female) who underwent FB-EVAR. Patients with treatment of the TA were younger (71.7 vs. 73.2 years, p < 0.001) and more often female (38.5% vs. 17.0%, p < 0.001) as compared to patients with treatment of TAA. In the TA group peripheral arterial disease was less frequent compared to the TAA group (67.3% vs. 80.4%, p = 0.036). Mortality was significantly (p < 0.001) higher following repair of the TAA compared to the TA at discharge (17.3% vs. 4.6%), at 30 days (26.9% vs. 8.2%) and at 90 days (34.6% vs. 10.1%). Patients with treatment of the TAA suffered more often from stroke as compared to the TA group (7.7% vs. 1.2%, p = 0.002).ConclusionIn this large-scale German analysis of claims data, multicenter real-world evidence was different from single center studies regarding patient risk-factors and outcome measures. Validated multicenter registry studies could help to further investigate this topic in times of increasing procedures.

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Renal outcomes analysis after endovascular and open aortic aneurysm repair

Abstract: Renal function impairment is similar after open and endovascular AAA repair. It is associated with a decrease in total renal volume, which seems to be an early and constant marker of postoperative renal impairment.

Cited by 29 publications

References 40 publications

Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms

Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms

Survival affects decision making for fenestrated and branched endovascular aortic repair

Complex endovascular treatment of intact aortic aneurysms

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