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Morphological State as a Predictor for Reintervention and Mortality After EVAR for AAA.

Ohrlander, Tomas; Dencker, Magnus LU and Acosta, Stefan LU (2011) In CardioVascular and Interventional Radiology
Abstract
PURPOSE: This study was designed to assess aorto-iliac morphological characteristics in relation to reintervention and all-cause long-term mortality in patients undergoing standard EVAR for infrarenal AAA. METHODS: Patients treated with EVAR (Zenith(®) Stentgrafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database where comorbidities and preoperative aneurysm morphology were entered. Reinterventions and mortality were checked until December 1, 2010. Median follow-up time was 68 months. RESULTS: A total of 304 patients were included, of which 86% were men. Median age was 74 years. The reintervention rate was 23.4% (71/304). A greater diameter of the common iliac artery (p = 0.037; hazard ratio... (More)
PURPOSE: This study was designed to assess aorto-iliac morphological characteristics in relation to reintervention and all-cause long-term mortality in patients undergoing standard EVAR for infrarenal AAA. METHODS: Patients treated with EVAR (Zenith(®) Stentgrafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database where comorbidities and preoperative aneurysm morphology were entered. Reinterventions and mortality were checked until December 1, 2010. Median follow-up time was 68 months. RESULTS: A total of 304 patients were included, of which 86% were men. Median age was 74 years. The reintervention rate was 23.4% (71/304). A greater diameter of the common iliac artery (p = 0.037; hazard ratio (HR) 1.037 [1.002-1.073]) was an independent factor for an increased number of reinterventions. The 30-day mortality rate was 3.0% (9/304). Aneurysm-related deaths due to AAA occurred in 4.9% (15/304). Five patients died due to a concomitant ruptured thoracic aortic aneurysm. The mortality until end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61.6%. The severity of angulation of the iliac arteries (p = 0.014; HR 1.018 [95% confidence interval (CI) 1.004-1.033]) and anemia (p = 0.044; HR 2.79 [95% CI 1.029-7.556]) remained as independent factors associated with all-cause long-term mortality. The crude reintervention-free survival rate at 1, 3, and 5 years was 84.5%, 64.8%, and 51.6%, respectively. CONCLUSIONS: The initial aorto-iliac morphological state in patients scheduled for standard EVAR for AAA seems to be strongly related to the need for reinterventions and long-term mortality. (Less)
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published
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CardioVascular and Interventional Radiology
publisher
Springer
external identifiers
  • wos:000308950200005
  • pmid:21769707
  • scopus:84867582972
ISSN
1432-086X
DOI
10.1007/s00270-011-0229-4
language
English
LU publication?
yes
id
ab5835e2-48f2-42f4-99bd-b885c08a9926 (old id 2058494)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21769707?dopt=Abstract
date added to LUP
2011-08-01 13:47:43
date last changed
2017-08-06 04:45:03
@article{ab5835e2-48f2-42f4-99bd-b885c08a9926,
  abstract     = {PURPOSE: This study was designed to assess aorto-iliac morphological characteristics in relation to reintervention and all-cause long-term mortality in patients undergoing standard EVAR for infrarenal AAA. METHODS: Patients treated with EVAR (Zenith(®) Stentgrafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database where comorbidities and preoperative aneurysm morphology were entered. Reinterventions and mortality were checked until December 1, 2010. Median follow-up time was 68 months. RESULTS: A total of 304 patients were included, of which 86% were men. Median age was 74 years. The reintervention rate was 23.4% (71/304). A greater diameter of the common iliac artery (p = 0.037; hazard ratio (HR) 1.037 [1.002-1.073]) was an independent factor for an increased number of reinterventions. The 30-day mortality rate was 3.0% (9/304). Aneurysm-related deaths due to AAA occurred in 4.9% (15/304). Five patients died due to a concomitant ruptured thoracic aortic aneurysm. The mortality until end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61.6%. The severity of angulation of the iliac arteries (p = 0.014; HR 1.018 [95% confidence interval (CI) 1.004-1.033]) and anemia (p = 0.044; HR 2.79 [95% CI 1.029-7.556]) remained as independent factors associated with all-cause long-term mortality. The crude reintervention-free survival rate at 1, 3, and 5 years was 84.5%, 64.8%, and 51.6%, respectively. CONCLUSIONS: The initial aorto-iliac morphological state in patients scheduled for standard EVAR for AAA seems to be strongly related to the need for reinterventions and long-term mortality.},
  author       = {Ohrlander, Tomas and Dencker, Magnus and Acosta, Stefan},
  issn         = {1432-086X},
  language     = {eng},
  month        = {07},
  publisher    = {Springer},
  series       = {CardioVascular and Interventional Radiology},
  title        = {Morphological State as a Predictor for Reintervention and Mortality After EVAR for AAA.},
  url          = {http://dx.doi.org/10.1007/s00270-011-0229-4},
  year         = {2011},
}