Vs05
laparoscopic Endovascular Aortobifemoral Bypass

Abstract

PurposeTo provide an overview of a predictive model of success that has been developed using the five-year results from the audit of endovascular aneurysm repair (EVAR). MethodologyPreoperative and operative EVAR information was collected from surgeons for procedures performed between November 1999 and May 2001. Annual follow-up has continued with a view to examining mid to longterm safety and effectiveness. Data was linked through the National Death Index to obtain accurate mortality information.A statistician applied generalised linear models (logistic regressions) on the data to predict measures of success. Stepwise forward logistic regressions were used to select which of the preoperative patient variables were included in each success measure model. Using this analysis, an interactive Microsoft Excel program was designed to help surgeons to evaluate the predicted likelihood of success of the procedure. ResultsEight predictor variables were used to assess relationships with various measure of success. Measures included technical success, likelihood of re-interventions, graft complications, migration, conversion to open, rupture, endoleak, mortality and survival. Copies of the model (Excel spreadsheet) were circulated to members of the audit reference group and other specialist vascular surgeons for comment. Clinical feedback was used to further refine the model and improve its utility. ConclusionsThe predictive model is available to vascular surgeons through the RACS website. It was developed as an aid for surgeons and patients to decide treatment options. Surgeons and patients can discuss patient's likely outcomes (e.g. complications and survival likelihood) to better inform the EVAR decision. PurposeAortic calcification is associated with subsequent cardiovascular events however relatively little is understood about its pathogenesis. This presentation describes on-going work to improve measurement, diagnosis and understanding of aortic calcification. MethodologyStudies have been carried out in a cohort of patients with peripheral artery disease and within an animal model. ResultsWe have developed and validated a technique to accurately assess the severity of infrarenal abdominal aortic calcification using CT angiography within patients. Utilising this technique we have investigated a number of potential blood tests to assess their value in determining aortic calcification severity. Within a mouse model of aortic calcification we are investigating the role of bone marrow derived cells in calcification development. ConclusionsFurther understanding of the mechanisms underlying aortic calcification may identify targets to treat calcification which are independent of those for atherosclerosis. PurposeAbdominal aortic aneurysm (AAA) is a common cause of mortality and at present no drug therapy is available. This presentation describes VS10 CAROTID ENDARTERECTOMY WITH EARLY ICA CONTROL: AN MRI STUDY