VESS9. Surgical Aneurysmorrhaphy to Preserve Autogenous Arteriovenous Fistula (aAVF) With Aneurysm-Related Complications

Abstract

CEA alone was performed in 581 symptomatic patients (32%) and in 1233 asymptomatic patients (68%). Stroke/ death/MI was 4.5% (2.8%/0.5%/1.2%) for symptomatic patients and 4.0% (2.4%/0.4%/1.1%) for asymptomatic patients. CEA and coronary artery bypass grafting (CABG) was performed in 155 patients (98.7% asymptomatic), S/D/MI of 11.1% (3.9%/5.8/%1.3%). Of 332 patients, CAS was performed in 119 symptomatic patients (36%) and in 213 asymptomatic patients (64%), with 255 (77%) treated as part of a Food and Drug Administrationapproved trial. S/D/MI was 9.2% (4.2%/4.2%/0.8%) for symptomatic patients and 5.2% (3.3%/1.4%/0.4%) for asymptomatic patients. Symptomatic CAS patients treated in a clinical trial (n ¼ 64) had two eventsdS/D/MI of 3.1% (3.1%/0%/0%). Symptomatic patients treated outside a clinical trial (n ¼ 55) had nine eventsdS/D/MI of 16.4% (5.5%/9%/1/1.8%). Conclusions: (1). The prospectively collected, independently verified S/D/MI rates for all CEA and CAS performed within a clinical trial were equivalent to the CREST results. (2) S/D/MI for CAS in symptomatic patients was significantly higher than CEA (9.2% vs 4.5%; P ¼ .034). (3). S/D/MI for CAS in symptomatic patients within a clinical trial was equivalent to CEA (3.1% vs 4.5%; P ¼ .759). Symptomatic CAS patients who did not qualify for a clinical trial had a five times increased risk of S/D/MI of 16.4%. (4) S/D/MI for CAS in asymptomatic patients was equivalent to CEA (5.2% vs 4.0%; P ¼ .42). (5). CEA/CABG in asymptomatic patients is associated with a three-times increased risk of S/D/MI compared with patients undergoing CEA for asymptomatic disease.