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Ilio-femoral calcium score may assist Glasgow Aneurysm Score prediction of long-term survival of low-risk patients after infrarenal EVAR

Vaccarino, Roberta LU ; Wachtmeister, Melker ; Sun, Jianming ; Bornè, Yan LU ; Resch, Timothy LU ; Sonesson, Björn LU and Dias, Nuno V LU orcid (2022) In International Angiology 41(4). p.285-291
Abstract

BACKGROUND: The aim of this study is to evaluate if ilio-femoral calcium score (CS) combined with Glasgow Aneurysm Score (GAS) can improve the prediction of long-term survival after EVAR.

METHODS: All the patients who underwent infrarenal endovascular aortic repair (EVAR) for non-ruptured AAA between January 2004 and December 2012 at a tertiary referral center were retrospectively included if the preoperative imaging was of sufficient quality and they had survived for more than 30 days. Preoperative non-contrast enhanced CT were used to measure ilio-femoral calcium score using dedicated postprocessing software. GAS was calculated and patients were divided into low or high GAS by a cutoff of 80.

RESULTS: Two hundred and... (More)

BACKGROUND: The aim of this study is to evaluate if ilio-femoral calcium score (CS) combined with Glasgow Aneurysm Score (GAS) can improve the prediction of long-term survival after EVAR.

METHODS: All the patients who underwent infrarenal endovascular aortic repair (EVAR) for non-ruptured AAA between January 2004 and December 2012 at a tertiary referral center were retrospectively included if the preoperative imaging was of sufficient quality and they had survived for more than 30 days. Preoperative non-contrast enhanced CT were used to measure ilio-femoral calcium score using dedicated postprocessing software. GAS was calculated and patients were divided into low or high GAS by a cutoff of 80.

RESULTS: Two hundred and eighty-eight out of 500 patients were included in the study with no difference in survival compared to excluded patients (P=0.529). Patients were followed-up for a median of 7 (range 4-9) years. GAS correlated positively with ilio-femoral calcium score (r=0.123; P=0.037). One hundred and thirty-five patients (46.9%) had low GAS, and 153 (53.1%) had high GAS. Patients with high GAS had lower survival compared to the ones with low GAS (P≤0.0001). GAS was associated with long-term mortality in a uni- and multivariate regression (P≤0.0001 and P≤0.0001). Ilio-femoral calcium score was significantly associated with mortality in the group with low GAS (P=0.028), but not in the group with high GAS (P=0.297). Significance retained in multivariate regression analysis (P=0.029). Moreover, in the low GAS group, ilio-femoral calcium score was further divided in high and low according to the median. Patients with high calcium score had lower survival compared to the ones with low calcium score (P=0.047).

CONCLUSIONS: Long-term survival in patients who have had infrarenal EVAR can be predicted by the clinically based Glasgow Aneurysm Score. Measuring the ilio-femoral calcium score preoperatively may refine GAS assessment in low-risk patients.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aortic Aneurysm, Abdominal/complications, Blood Vessel Prosthesis Implantation/methods, Calcium, Endovascular Procedures/adverse effects, Humans, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome
in
International Angiology
volume
41
issue
4
pages
285 - 291
publisher
Minerva Medica
external identifiers
  • pmid:35583456
  • scopus:85135380382
ISSN
1827-1839
DOI
10.23736/S0392-9590.22.04883-0
language
English
LU publication?
yes
id
70872cdb-0d01-4448-957d-5b43e40788ad
date added to LUP
2022-07-29 23:08:20
date last changed
2024-06-28 22:05:31
@article{70872cdb-0d01-4448-957d-5b43e40788ad,
  abstract     = {{<p>BACKGROUND: The aim of this study is to evaluate if ilio-femoral calcium score (CS) combined with Glasgow Aneurysm Score (GAS) can improve the prediction of long-term survival after EVAR.</p><p>METHODS: All the patients who underwent infrarenal endovascular aortic repair (EVAR) for non-ruptured AAA between January 2004 and December 2012 at a tertiary referral center were retrospectively included if the preoperative imaging was of sufficient quality and they had survived for more than 30 days. Preoperative non-contrast enhanced CT were used to measure ilio-femoral calcium score using dedicated postprocessing software. GAS was calculated and patients were divided into low or high GAS by a cutoff of 80.</p><p>RESULTS: Two hundred and eighty-eight out of 500 patients were included in the study with no difference in survival compared to excluded patients (P=0.529). Patients were followed-up for a median of 7 (range 4-9) years. GAS correlated positively with ilio-femoral calcium score (r=0.123; P=0.037). One hundred and thirty-five patients (46.9%) had low GAS, and 153 (53.1%) had high GAS. Patients with high GAS had lower survival compared to the ones with low GAS (P≤0.0001). GAS was associated with long-term mortality in a uni- and multivariate regression (P≤0.0001 and P≤0.0001). Ilio-femoral calcium score was significantly associated with mortality in the group with low GAS (P=0.028), but not in the group with high GAS (P=0.297). Significance retained in multivariate regression analysis (P=0.029). Moreover, in the low GAS group, ilio-femoral calcium score was further divided in high and low according to the median. Patients with high calcium score had lower survival compared to the ones with low calcium score (P=0.047).</p><p>CONCLUSIONS: Long-term survival in patients who have had infrarenal EVAR can be predicted by the clinically based Glasgow Aneurysm Score. Measuring the ilio-femoral calcium score preoperatively may refine GAS assessment in low-risk patients.</p>}},
  author       = {{Vaccarino, Roberta and Wachtmeister, Melker and Sun, Jianming and Bornè, Yan and Resch, Timothy and Sonesson, Björn and Dias, Nuno V}},
  issn         = {{1827-1839}},
  keywords     = {{Aortic Aneurysm, Abdominal/complications; Blood Vessel Prosthesis Implantation/methods; Calcium; Endovascular Procedures/adverse effects; Humans; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{285--291}},
  publisher    = {{Minerva Medica}},
  series       = {{International Angiology}},
  title        = {{Ilio-femoral calcium score may assist Glasgow Aneurysm Score prediction of long-term survival of low-risk patients after infrarenal EVAR}},
  url          = {{http://dx.doi.org/10.23736/S0392-9590.22.04883-0}},
  doi          = {{10.23736/S0392-9590.22.04883-0}},
  volume       = {{41}},
  year         = {{2022}},
}