ENDOVASCULAR ANEURYSM REPAIR FOR INTACT AND RUPTURED ABDOMINAL AORTIC ANEURYSMS: SHOULD WE EXPECT MORE COMPLICATIONS AFTER R-EVAR?

Detalhes bibliográficos
Autor(a) principal: Oliveira Pinto, José
Data de Publicação: 2018
Outros Autores: Sousa, Joel, Neves, João Rocha, Leite-Moreira, Adelino, Mansilha, Armando
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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spelling 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
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.48750/acv.63
oai:ojs.acvjournal.com:article/63
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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)
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instacron_str RCAAP
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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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