Author + information
- Masayuki Sakaki,
- Nobuhiro Handa,
- Toshihiro Onohara,
- Masakazu Kawasaki,
- Fuminori Kasashima,
- Masahiro Okada,
- Tsuyoshi Yamamoto,
- Minoru Okamoto,
- Masafumi Yamashita,
- Katsutoshi Sato,
- Shingo Ishiguro,
- Yasushi Shimoe and
- Jyunji Kishimoto
Background: Although endovascular aneurysm repair (EVAR) Is a first line treatment modality for abdominal aortic aneurysm (AAA), the requirement of late intervention Is still a concern. The purpose of the present study Is to reveal the late intervention After EVAR.
Methods: Fourteen national hospitals in Japan registered the AAA cases (n=812: age:77.2±7.5, male gender: 82%) retrospectively between 2007 and 2013 and late event has been collected prospectively. Patients had several co-morbidities including coronary artery disease in 35.1%, history of stroke in 20.1%, abdominal surgery in 22.5% and active malignancy on treatment in 7.2%. EVAR was indicated for 26.4% of patients having AAA which was beyond instruction for use (IFU). Kaplan-Meier estimate and Cox proportional hazard model (CPHM) was constructed for all cause death, aneurysm related death, late intervention and late surgical conversion
Results: Total follow-up term was 2626 patient year (3.23±2.0 years). Surgical mortality was 13 patients (1.6%). Late death included 34 patients Who died of aneurysm related death, 38 of cardiovascular death and 81 of non-cardiovascular causes. The survival rate free of all cause death and aneurysm related death at 5 years was 74.7±2.0% and 94.7±1.1% respectively. CPHM for aneurysm related death identified predictors of age (P=0.0005), smoking history (P=0.0328), hypertension (P=0.0464), AAA size (P=0.0428). Late intervention includes re-graft replacement (n=9), Sacotomy and ligation of side branch endoleaks (n=12), femoro-femoral bypass (n=8), thrombectomy (n=6) and endovascular procedure (n=64). The survival rate free of late intervention and surgical conversion at 5 years was 84.6±1.8% and 93.7±1.2% respectively. CPHM for late intervention identified single predictor of AAA size (P=0.0003). CPHM for late surgical conversion identified predictors of AAA size (P=0.0004) and beyond IFU (P=0.0452)
Conclusions: The rates of late intervention and surgical conversion were Not negligible. As late intervention and surgical conversion were related with large AAA at the time of EVAR, close surveillance Is mandatory if AAA size Is large.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-125
- 2017 American College of Cardiology Foundation