The Effect of Age on Post-EVAR Outcomes

Png, C.Y. Maximilian; Tadros, Rami O.; Faries, Peter L.; Torres, Marielle; Kim, Sung Yup; Lookstein, R.; Vouyouka, Ageliki G.; Marin, Michael L.

doi:10.1016/j.avsg.2016.01.022

Cited by 23 publications

(12 citation statements)

References 20 publications

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“…The ENGAGE registry consisted of older patients with higher American Society of Anaesthesiologists' (ASA) scores, which is associated with an increased need for secondary interventions. 35 Despite the more challenging cohort, the five year freedom from secondary endovascular procedures was 84.3% in the ENGAGE registry. There still remains room for improvement as open repair can have a freedom from re-intervention rate above 90%.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…The etiology of the aneurysm should also be considered; mycotic aneurysms are typically not treated endovascularly unless performed as a temporizing measure 11 . In our patient, one factor in favor of endovascular intervention was his relatively young age affording him a decreased risk of stroke compared to CEA 12, 13…”

Section: Discussionmentioning

confidence: 83%

Transradial stenting of a carotid pseudoaneurysm

Png

Faries

Han

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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“… 17 Age of more than 70 years correlates with only a small increase in major perioperative complications (7.5% vs 4.8%). 18 The EUROSTAR study demonstrated that EVAR patients return to preoperative status sooner. 19 In the 80- to 99-year-old age group, multiple studies have shown EVAR is safe and effective with acceptable risk profile.…”

Section: Discussionmentioning

confidence: 99%

Endovascular abdominal aortic aneurysm repair in a centenarian

Bellamkonda

Kim

Rosenthal

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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As the general population ages, there will be an increasing number of vascular patients in their 90s and older. However, geriatric patients have historically been turned down for abdominal aortic aneurysm repair despite high aneurysm-related mortality in the unrepaired. Herein, we describe the perioperative considerations and the successful, uncomplicated operative course of a 100-year-old woman who underwent an elective endovascular aortic aneurysm repair for an expanding 5.3-cm abdominal aortic aneurysm. Given a suitable patient, there is acceptable risk profile of an endovascular approach, even in centenarians.

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The Effect of Age on Post-EVAR Outcomes

Cited by 23 publications

References 20 publications

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

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

Transradial stenting of a carotid pseudoaneurysm

Endovascular abdominal aortic aneurysm repair in a centenarian

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