Adjuvant procedures performed during endovascular repair of abdominal aortic aneurysm. does it influence outcome?

Eur J Vasc Endovasc Surg. 2005 Jul;30(1):20-8. doi: 10.1016/j.ejvs.2005.02.031.

Abstract

Objective: The purpose of this study was to assess whether there is a difference in outcome of endovascular repair in patients with and without intraoperative adjuvant procedures.

Methods: Demographic, anatomic and operative details were assessed in patients undergoing endovascular repair using the EUROSTAR registry and correlated with morbidity and mortality rates. Three groups of adjuvant procedures: (A) endovascular, (B) surgical peripheral arterial and (C) surgical abdominal arterial were compared with a group of patients without an adjuvant procedure (D). Logistic regression and Cox proportional hazards model were used for statistical analysis.

Results: Of 4631 endovascular repairs, 1353 patients (29.2%) required adjuvant procedures. Additional endovascular procedures were performed in 1057 (78.1%), surgical peripheral arterial in 193 (14.3%) and surgical abdominal arterial in 103 (7.6%). The 30-day mortality rate was significantly higher in categories with peripheral arterial surgical (6.7%) and abdominal surgical procedures (7.8%) compared to patients without adjuvant procedures (1.5%, p = .001 and p = .004, respectively). Life-table-analysis demonstrated that late mortality, conversion or rupture rates were not increased in patients with an adjuvant procedure.

Conclusion: Adjuvant surgical procedures were associated with increased 30-day mortality. Because of this higher risk, endovascular repair should be recommended with caution when surgical adjuvant procedures are anticipated.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Angioplasty, Balloon / methods
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography
  • Blood Vessel Prosthesis Implantation
  • Embolization, Therapeutic / methods
  • Endarterectomy / methods
  • Female
  • Femoral Artery / surgery
  • Follow-Up Studies
  • Humans
  • Intraoperative Period
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Severity of Illness Index
  • Survival Rate
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler
  • Vascular Surgical Procedures / methods*