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Mortality after endovascular treatment of infrarenal abdominal aortic aneurysms - the newer the better?

Publication ,  Journal Article
Tzani, A; Doulamis, IP; Katsaros, I; Martinou, E; Schizas, D; Economopoulos, KP
Published in: VASA. Zeitschrift fur Gefasskrankheiten
April 2018

Although endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) presents a delicate alternative treatment for abdominal aortic aneurysms (AAA) with lower perioperative mortality, its long-term efficacy remains a matter of concern. The purpose of this study was to evaluate the currently reported mortality evidence after EVAR and to examine the possible effect of aneurysm status and the study period on mortality rates. The PubMed and Cochrane bibliographical databases were thoroughly searched for studies reporting on more than 1 000 patients with non-ruptured or ruptured infrarenal AAA, treated with EVAR from August 1991 to September 2016. A total of 10 910 titles/abstracts were retrieved and 121 studies were deemed relevant. Twenty-six studies met the inclusion criteria and reported on 354 500 patients with a mean age of 74.6 years. Almost all of the studies referred to elective EVAR and the mean aneurysm size was 5.58 cm. The most common early complication for elective EVAR was perioperative bleeding (1.9 %), whereas hospital-acquired pneumonia was a major concern in urgent EVAR (28.5 %). Conversion rate to open surgery was 1.2 %. The 30-day all-cause mortality rate was 4.84 % (1.7 % for non- ruptured aneurysms, 33.8 % for ruptured aneurysms).The overall all-cause late mortality in a mean follow-up period of 23.8 months was 19.1 %. The aneurysm-related late mortality rate was 3.4 %. With respect to the time period of patient enrollment, studies reporting on patients recruited before 2006 were found to face more secondary complications and higher late mortality rates than patients enrolled after 2005.The endovascular treatment of large and anatomically suitable infrarenal AAA in selected patients remains a safe alternative to open repair. Our findings demonstrate that newer studies show better long-term outcomes than the older ones, proposing a possible improvement of EVAR techniques and perioperative care and providing encouraging evidence for a wider application of EVAR.

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Published In

VASA. Zeitschrift fur Gefasskrankheiten

DOI

EISSN

1664-2872

ISSN

0301-1526

Publication Date

April 2018

Volume

47

Issue

3

Start / End Page

187 / 196

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Postoperative Complications
  • Humans
  • Endovascular Procedures
  • Cardiovascular System & Hematology
  • Blood Vessel Prosthesis Implantation
  • Aortic Aneurysm, Abdominal
  • 3203 Dentistry
 

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Tzani, A., Doulamis, I. P., Katsaros, I., Martinou, E., Schizas, D., & Economopoulos, K. P. (2018). Mortality after endovascular treatment of infrarenal abdominal aortic aneurysms - the newer the better? VASA. Zeitschrift Fur Gefasskrankheiten, 47(3), 187–196. https://doi.org/10.1024/0301-1526/a000685
Tzani, Aspasia, Ilias P. Doulamis, Ioannis Katsaros, Eirini Martinou, Dimitrios Schizas, and Konstantinos P. Economopoulos. “Mortality after endovascular treatment of infrarenal abdominal aortic aneurysms - the newer the better?VASA. Zeitschrift Fur Gefasskrankheiten 47, no. 3 (April 2018): 187–96. https://doi.org/10.1024/0301-1526/a000685.
Tzani A, Doulamis IP, Katsaros I, Martinou E, Schizas D, Economopoulos KP. Mortality after endovascular treatment of infrarenal abdominal aortic aneurysms - the newer the better? VASA Zeitschrift fur Gefasskrankheiten. 2018 Apr;47(3):187–96.
Tzani, Aspasia, et al. “Mortality after endovascular treatment of infrarenal abdominal aortic aneurysms - the newer the better?VASA. Zeitschrift Fur Gefasskrankheiten, vol. 47, no. 3, Apr. 2018, pp. 187–96. Epmc, doi:10.1024/0301-1526/a000685.
Tzani A, Doulamis IP, Katsaros I, Martinou E, Schizas D, Economopoulos KP. Mortality after endovascular treatment of infrarenal abdominal aortic aneurysms - the newer the better? VASA Zeitschrift fur Gefasskrankheiten. 2018 Apr;47(3):187–196.

Published In

VASA. Zeitschrift fur Gefasskrankheiten

DOI

EISSN

1664-2872

ISSN

0301-1526

Publication Date

April 2018

Volume

47

Issue

3

Start / End Page

187 / 196

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Postoperative Complications
  • Humans
  • Endovascular Procedures
  • Cardiovascular System & Hematology
  • Blood Vessel Prosthesis Implantation
  • Aortic Aneurysm, Abdominal
  • 3203 Dentistry