| Autor: |
Waduud, M., Ritchie, M., Yadavali, R., Lim, S.H., Buchanan, F., Choong, W., Ramanathan, K., Ingram, S., Cormack, L., Moss, J. |
| Zdroj: |
Journal of Vascular & Interventional Radiology; Mar2014 Supplement, Vol. 25 Issue 3, pS14-S15, 0p |
| Abstrakt: |
Purpose: EVAR is the dominant treatment strategy for abdominal aortic aneurysms. However due to uncertainty regarding long term durability an on-going imaging surveillance programme is required. The aim was to assess the deliverability and its effect on all-cause and aneurysm-related mortality. Materials and Methods: A retrospective analysis of all EVAR procedures carried out in the four main Scottish Vascular Units. Patients were identified locally and imaging data collected by manually searching a combination of different databases. Complete imaging follow-up was defined as following the local protocol for each site and subsequent continuing annual imaging. Outcome measures included all-cause mortality and aneurysm-related mortality. Cause of death was obtained from the death certificate. Results: Data was available for 569 patients from 2001-2012. All centres had data for a minimum of 5 contiguous years. Follow up period ranged from 1.66 to 4.55 years (median 3.03). Overall 53% had complete imaging surveillance, 43% partial and 7% none. For the whole cohort all-cause 5 year mortality was 33.5% and aneurysm-related mortality was 4.5%. All-cause mortality in patients with complete, partial and no imaging was 49.9%, 19.1% and 47.2% and aneurysm-related mortality was 3.7%, 4.4% and 9.5% respectively. All-cause mortality was significant higher in patients with complete imaging surveillance (p<0.001). No significant differences was observed in aneurysm related mortality (p=0.2). Conclusion: Only half of EVAR patients achieve complete long-term imaging surveillance over a minimum 5 year period. However incomplete imaging could not be linked to any increase in mortality. This information may have implications for the national screening programme. [Copyright &y& Elsevier] |
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