uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Outcomes after endovascular repair of abdominal aortic aneurysm involving the renovisceral arteries: A multi-center follow-up study
Soder Sjukhuset, Sect Vasc Surg, Dept Clin Sci & Educ, Karolinska Inst, Stockholm, Sweden;Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol, Stockholm, Sweden.
Karolinska Univ Hosp, Karolinska Inst, MMK, Dept Vasc Surg, Solna, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.ORCID iD: 0000-0002-4224-5351
Karolinska Univ Hosp, Karolinska Inst, MMK, Dept Vasc Surg, Solna, Sweden.ORCID iD: 0000-0001-7323-6063
Show others and affiliations
2019 (English)In: Vascular, ISSN 1708-5381, E-ISSN 1708-539X, Vol. 27, no 4, p. 397-404Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate outcomes after endovascular treatment of abdominal aortic aneurysms (AAA) involving the renovisceral arteries and to compare outcomes after fenestrated/branched endovascular aortic repair (f/b-EVAR), chimney/periscope EVAR (ch-EVAR), and bailout ch-EVAR.

Methods: A retrospective multicenter study including all patients with AAA involving the renovisceral segment, treated with f/b-EVAR, ch-EVAR, or bailout ch-EVAR, between 1 January 2005 and 30 June 2015, in three Swedish vascular centers. Patient charts were reviewed for data. Renovisceral stent graft patency was assessed on follow-up CT. Mortality was cross-checked against the Swedish Population Registry. Bailout ch-EVAR was defined as a perioperative decision of renovisceral endografting, as the artery was accidentally covered, or as the aneurysm neck sealing zone was considered inadequate.

Results: Of the 99 identified patients (76 men; mean age 74 years (range 58-89 years)), 68 underwent f/b-EVAR, 18 ch-EVAR, and 13 bailout ch-EVAR. Follow-up lasted for a median of 3.2 years (Q1, Q3 (2.1, 4.7 years)). Elective surgery comprised 87.9% (n = 87) of the cases. Six patients died within 30 days, and the 30-day mortality after elective surgery was 4.6% (95% CI, 1.3%-11.4%) overall, 1.6% after f/b-EVAR (95% CI, 0.0%-11.4%), 15.4% after ch-EVAR (95% CI, 1.9%-45.4%), and 10.0% (95% CI, 0.3%-44.5%) after bailout ch-EVAR. During follow-up, there were 16 secondary interventions, of which 75% (n = 12) were performed within six months after the primary intervention. Compared with f/b-EVAR, ch-EVAR was associated with a higher degree of type 1 endoleaks (1.5% vs. 22.2%, P = 0.001) and re-interventions during follow-up (13.2% vs. 33.3%, P = 0.046). The overall assisted target vessel patency was 96.1% (95% CI, 91.7%-98.6%) at one year and 95.2% (95% CI, 89.2%-98.4%) at two years.

Conclusions: Results after EVAR involving endografting of renovisceral arteries from three centers in Sweden with medium volumes are consistent with results previously reported from centers with larger volumes.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2019. Vol. 27, no 4, p. 397-404
Keywords [en]
Abdominal aortic aneurysm, endovascular aneurysm repair, patency, mortality, outcome analysis
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-391295DOI: 10.1177/1708538119836016ISI: 000476526100009PubMedID: 30871441OAI: oai:DiVA.org:uu-391295DiVA, id: diva2:1344779
Available from: 2019-08-22 Created: 2019-08-22 Last updated: 2019-08-22Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Mani, KevinWanhainen, Anders

Search in DiVA

By author/editor
Mani, KevinLundberg, GöranWanhainen, AndersGillgren, Peter
By organisation
Vascular Surgery
In the same journal
Vascular
Surgery

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 6 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf