ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR?
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.63 |
Resumo: | Introduction: Endovascular Aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (r-AAA) has been increasingly advocated due to short term benefits. Survival after discharge seems to be similar between EVAR for rAAA (r-EVAR) and for elective patients (el-EVAR). Still, due to higher anatomical complexity more graft-related complications may arise in r-EVAR patients. Methods: MEDLINE databases were searched to identify publications reporting on outcomes after r-EVAR and el-EVAR. Landmark EVAR randomized controlled trial results were used as comparison. Results: After-discharge outcomes (other than mortality), were reported in 5 studies including 509 r-EVAR patients. A direct comparison between r-EVAR and el-EVAR patients was found in 2 studies, including 2895 patients (256 r-EVAR and 2653 el-EVAR). Type I endoleak rates ranged from 5.4-21% in r- EVAR and from 4.4-10% el-EVAR. Rates of secondary intervention in r-EVAR ranged between 16.7-76% and in el-EVAR from 11-27.7%. Five year rate of complications after r-EVAR inside instructions for use were 8.8% and reinterventions were 16.7%. Conclusions: r-EVAR patients present higher rates of type I endoleaks and secondary interventions. However, when complying with IFU, aneurysm-related complications overlap to the el-EVAR patients. Surveillance strategies should be tailored according to the baseline anatomical complexity and early complications and not to the timing of repair. |
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ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR?CORREÇÃO ENDOVASCULAR DE ANEURISMAS DA AORTA ABDOMINAL ROTOS E ELETIVOS: DEVEMOS ESPERAR MAIS COMPLICAÇÕES APÓS R-EVAR?Ruptured Abdominal Aortic AneurysmsEndovascular Aneurysm RepairOutcomesAneurisma roto da Aorta AbdominalCorreção Endovascular de AneurismaResultadosIntroduction: Endovascular Aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (r-AAA) has been increasingly advocated due to short term benefits. Survival after discharge seems to be similar between EVAR for rAAA (r-EVAR) and for elective patients (el-EVAR). Still, due to higher anatomical complexity more graft-related complications may arise in r-EVAR patients. Methods: MEDLINE databases were searched to identify publications reporting on outcomes after r-EVAR and el-EVAR. Landmark EVAR randomized controlled trial results were used as comparison. Results: After-discharge outcomes (other than mortality), were reported in 5 studies including 509 r-EVAR patients. A direct comparison between r-EVAR and el-EVAR patients was found in 2 studies, including 2895 patients (256 r-EVAR and 2653 el-EVAR). Type I endoleak rates ranged from 5.4-21% in r- EVAR and from 4.4-10% el-EVAR. Rates of secondary intervention in r-EVAR ranged between 16.7-76% and in el-EVAR from 11-27.7%. Five year rate of complications after r-EVAR inside instructions for use were 8.8% and reinterventions were 16.7%. Conclusions: r-EVAR patients present higher rates of type I endoleaks and secondary interventions. However, when complying with IFU, aneurysm-related complications overlap to the el-EVAR patients. Surveillance strategies should be tailored according to the baseline anatomical complexity and early complications and not to the timing of repair.Introdução: O tratamento Endovascular do Aneurisma da Aorta Abdominal em rotura (r-EVAR) tem sido progressivamente adotado devido aos benefícios no curto prazo. A sobrevida após alta hospitalar parece semelhante entre r-EVAR e doentes operados eletivamente (el-EVAR). Ainda assim, devido à maior complexidade anatómica é expectável um maior risco de complicações relacionadas com o aneurisma após r-EVAR. Métodos: Bases de dados MEDLINE foram pesquisadas no sentido de identificar publicações reportando outcomes após r-EVAR e el-EVAR. Ensaios clínicos randomizados foram usados para comparação. Resultado: Após a alta outcomes (except mortalidade), foram reportados em 5 estudos incluindo 509 pacientes r-EVAR. Comparação direta entre r-EVAR e el-EVAR foi encontrada em dois estudos incluindo 2895 doentes (256 r-EVAR and 2653 el-EVAR). Taxas de endoleak tipo I variaram entre 5.4-21% para o grupo r-EVAR e entre 4.4-10% no grupo el-EVAR. Taxas de rintervenções no grupo r-EVAR variaram entre 16.7-76% e entre 11-27.7% no grupo i-EVAR. Taxa de complicações aos 5 anos após r-EVAR dentro das instructions for use (IFU) foi de 8.8% e reiintervenções de 16.7%. Conclusão: Pacientes r-EVAR apresentam taxas mais altas de endoleaks tipo I e ntervenções secundárias. Contudo, quando dentro das IFU, as taxas de complicações relacionadas com o aneurisma são sobreponíveis ao el-EVAR. Estratégias de follow-up devem ser ajustadas de acordo com a anatomia basal e complicações precoces e não de acordo com timing de reparação.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2018-12-02T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.63oai:ojs.acvjournal.com:article/63Angiologia e Cirurgia Vascular; Vol. 14 No. 1 (2018): March; 47-52Angiologia e Cirurgia Vascular; Vol. 14 N.º 1 (2018): Março; 47-522183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/63https://doi.org/10.48750/acv.63http://acvjournal.com/index.php/acv/article/view/63/80Copyright (c) 2018 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessOliveira Pinto, JoséSousa, JoelNeves, João RochaLeite-Moreira, AdelinoMansilha, Armando2022-05-23T15:10:00Zoai:ojs.acvjournal.com:article/63Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:28.642121Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? CORREÇÃO ENDOVASCULAR DE ANEURISMAS DA AORTA ABDOMINAL ROTOS E ELETIVOS: DEVEMOS ESPERAR MAIS COMPLICAÇÕES APÓS R-EVAR? |
title |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? |
spellingShingle |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? Oliveira Pinto, José Ruptured Abdominal Aortic Aneurysms Endovascular Aneurysm Repair Outcomes Aneurisma roto da Aorta Abdominal Correção Endovascular de Aneurisma Resultados |
title_short |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? |
title_full |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? |
title_fullStr |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? |
title_full_unstemmed |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? |
title_sort |
ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR? |
author |
Oliveira Pinto, José |
author_facet |
Oliveira Pinto, José Sousa, Joel Neves, João Rocha Leite-Moreira, Adelino Mansilha, Armando |
author_role |
author |
author2 |
Sousa, Joel Neves, João Rocha Leite-Moreira, Adelino Mansilha, Armando |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Oliveira Pinto, José Sousa, Joel Neves, João Rocha Leite-Moreira, Adelino Mansilha, Armando |
dc.subject.por.fl_str_mv |
Ruptured Abdominal Aortic Aneurysms Endovascular Aneurysm Repair Outcomes Aneurisma roto da Aorta Abdominal Correção Endovascular de Aneurisma Resultados |
topic |
Ruptured Abdominal Aortic Aneurysms Endovascular Aneurysm Repair Outcomes Aneurisma roto da Aorta Abdominal Correção Endovascular de Aneurisma Resultados |
description |
Introduction: Endovascular Aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (r-AAA) has been increasingly advocated due to short term benefits. Survival after discharge seems to be similar between EVAR for rAAA (r-EVAR) and for elective patients (el-EVAR). Still, due to higher anatomical complexity more graft-related complications may arise in r-EVAR patients. Methods: MEDLINE databases were searched to identify publications reporting on outcomes after r-EVAR and el-EVAR. Landmark EVAR randomized controlled trial results were used as comparison. Results: After-discharge outcomes (other than mortality), were reported in 5 studies including 509 r-EVAR patients. A direct comparison between r-EVAR and el-EVAR patients was found in 2 studies, including 2895 patients (256 r-EVAR and 2653 el-EVAR). Type I endoleak rates ranged from 5.4-21% in r- EVAR and from 4.4-10% el-EVAR. Rates of secondary intervention in r-EVAR ranged between 16.7-76% and in el-EVAR from 11-27.7%. Five year rate of complications after r-EVAR inside instructions for use were 8.8% and reinterventions were 16.7%. Conclusions: r-EVAR patients present higher rates of type I endoleaks and secondary interventions. However, when complying with IFU, aneurysm-related complications overlap to the el-EVAR patients. Surveillance strategies should be tailored according to the baseline anatomical complexity and early complications and not to the timing of repair. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-12-02T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.63 oai:ojs.acvjournal.com:article/63 |
url |
https://doi.org/10.48750/acv.63 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/63 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/63 https://doi.org/10.48750/acv.63 http://acvjournal.com/index.php/acv/article/view/63/80 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 14 No. 1 (2018): March; 47-52 Angiologia e Cirurgia Vascular; Vol. 14 N.º 1 (2018): Março; 47-52 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799129848666390528 |