Endovascular aneurysm repair: is imaging surveillance robust, and does it influence long-term mortality? (original) (raw)
Waduud, M. A. et al. (2015) Endovascular aneurysm repair: is imaging surveillance robust, and does it influence long-term mortality?CardioVascular and Interventional Radiology, 38(1), pp. 33-39. (doi: 10.1007/s00270-014-0890-5)
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Abstract
Purpose: Endovascular aneurysm repair (EVAR) is the dominant treatment strategy for abdominal aortic aneurysms. However, as a result of uncertainty regarding long-term durability, an ongoing imaging surveillance program is required. The aim of the study was to assess EVAR surveillance in Scotland and its effect on all-cause and aneurysm-related mortality.
Methods: A retrospective analysis of all EVAR procedures carried out in the four main Scottish vascular units. The primary outcome measure was the implementation of post-EVAR imaging surveillance across Scotland. Patients were identified locally and then categorized as having complete, incomplete, or no surveillance. Secondary outcome measures were all-cause mortality and aneurysm-related mortality. Cause of death was obtained from death certificates. Results: Data were available for 569 patients from the years 2001 to 2012. All centers had data for a minimum of 5 contiguous years. Surveillance ranged from 1.66 to 4.55 years (median 3.03 years). Overall, 53 % had complete imaging surveillance, 43 % incomplete, and 4 % none. For the whole cohort, all-cause 5-year mortality was 33.5 % (95 % confidence interval 28.0–38.6) and aneurysm-related mortality was 4.5 % (.8–7.3). All-cause mortality in patients with complete, incomplete, and no imaging was 49.9 % (39.2–58.6), 19.1 % (12.6–25.2), and 47.2 % (17.7–66.2), respectively. Aneurysm-related mortality was 3.7 % (1.8–7.4), 4.4 % (2.2–8.9), and 9.5 % (2.5–33.0), respectively. All-cause mortality was significantly higher in patients with complete compared to incomplete imaging surveillance (p < 0.001). No significant differences were observed in aneurysm-related mortality (p = 0.2). Conclusion: Only half of EVAR patients underwent complete long-term imaging surveillance. However, incomplete imaging could not be linked to any increase in mortality. Further work is required to establish the role and deliverability of EVAR imaging surveillance.| Item Type: | Articles |
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| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Moss, Professor Jonathan and Sim, Ms Moira and Williams, Miss Claire |
| Authors: | Waduud, M. A., Choong, W. L., Ritchie, M., Williams, C., Yadavali, R., Lim, S., Buchanan, F., Bhat, R., Ramanathan, K., Ingram, S., Cormack, L., and Moss, J. G. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology AssessmentCollege of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSUCollege of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | CardioVascular and Interventional Radiology |
| Publisher: | Springer US |
| ISSN: | 0174-1551 |
| ISSN (Online): | 1432-086X |
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Deposit and Record Details
| ID Code: | 102645 |
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| Depositing User: | Miss Fiona Doyle |
| Datestamp: | 16 Feb 2015 12:36 |
| Last Modified: | 02 May 2025 05:10 |
| Date of first online publication: | 1 February 2015 |