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Institutional Impact of EVAR's Incorporation in the Treatment of Abdominal Aortic Aneurysm: a 12 Years' Experience Analysis

2016-04Journal article Open access
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dc.contributor.authorMachado, R.
dc.contributor.authorAntunes, I.
dc.contributor.authorOliveira, P.
dc.contributor.authorPereira, C.
dc.contributor.authorAlmeida, R.
dc.date.accessioned2017-05-22T09:44:37Z
dc.date.available2017-05-22T09:44:37Z
dc.date.issued2016-04
dc.description.abstractIntroduction: Endovascular aneurysm repair (EVAR) was introduced as a less aggressive treatment of abdominal aortic aneurysms (AAA) for patients ineligible for open repair (OR). Objective: To analyze EVAR's incorporation impact in the treatment of infra-renal abdominal aortic aneurysms in our institution. Methods: A retrospective study of the patients with diagnostic of infra-renal AAA treated between December 2001 and December 2013 was performed. The choice between EVAR and OR was based on surgeon's experience, considering patient clinical risk and aneurysm's anatomical features. Patients treated by EVAR and by OR were analyzed. In each group, patient's and aneurysm's characteristics, surgical and anesthesia times, cost, transfusion rate, intraoperative complications, hospital stay, mortality and re-intervention rates and survival curves were evaluated. Results: The mean age, all forms of heart disease and chronic renal failure were more common in EVAR group. Blood transfusion, surgical and anesthesia times and mean hospital stay were higher for OR. Intraoperative complications rate was higher for endovascular aneurysm repair, overall during hospitalization complication rate was higher for open repair. The average cost in endovascular aneurysm repair was 1448.3€ higher. Re-interventions rates within 30 days and late re-intervention were 4.1% and 11.7% for endovascular aneurysm repair versus 13.7% and 10.6% for open repair. Conclusions: Two different groups were treated by two different techniques. The individualized treatment choice allows to achieve a mortality of 2.7%. Age ≥80 years influences survival curve in OR group and ASA ≥IV in EVAR group. We believe EVAR's incorporation improved the results of OR itself. Patients with more comorbidities were treated by endovascular aneurysm repair, decreasing those excluded from treatment. Late reinterventions were similar for both techniques.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBraz J Cardiovasc Surg. 2016 Apr;31(2):98-105.pt_PT
dc.identifier.doi10.5935/1678-9741.20160028pt_PT
dc.identifier.issn0102-7638
dc.identifier.issn1678-9741
dc.identifier.urihttp://hdl.handle.net/10400.16/2095
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBrazilian Society of Cardiovascular Surgerypt_PT
dc.relation.publisherversionhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382016000200098&lng=en&nrm=iso&tlng=enpt_PT
dc.subjectAortic Aneurysmpt_PT
dc.subjectAbdominalpt_PT
dc.subjectEndovascular Procedurespt_PT
dc.subjectVascular Surgical Procedurespt_PT
dc.subjectHealth Riskpt_PT
dc.titleInstitutional Impact of EVAR's Incorporation in the Treatment of Abdominal Aortic Aneurysm: a 12 Years' Experience Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceBrazilpt_PT
oaire.citation.endPage105pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage98pt_PT
oaire.citation.titleBrazilian Journal of Cardiovascular Surgerypt_PT
oaire.citation.volume31pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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