Characterization of Secondary Interventions After Fenestrated-branched Endovascular Repair of Complex Aortic Aneurysms and Its Effect on Quality of Life and Patient Survival.
Ann Surg
; 278(1): 140-147, 2023 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-35801701
ABSTRACT
OBJECTIVE:
To assess the impact of secondary intervention (SI) on health-related quality of life (HR-QOL) after fenestrated-branched endovascular aortic repair (FB-EVAR) for complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms.BACKGROUND:
The effect of SI after FB-EVAR on physical and mental HR-QOL has not been described.METHODS:
A cohort of 430 consecutive patients enrolled in a prospective, nonrandomized study to evaluate FB-EVAR (2013-2020) was assessed with 1325 short-form 36 HR-QOL questionnaires preoperatively and during follow-up visits. SIs were classified as major or minor procedures. Endpoints included patient survival, freedom from aortic-related mortality (ARM), freedom from SIs, and changes in HR-QOL physical component score (PCS) and mental component score.RESULTS:
There were 302 male with mean age 74±8 years treated by FB-EVAR for 133 complex abdominal aortic aneurysms and 297 thoracoabdominal aortic aneurysms. After a mean follow up of 26±20 months, 97 patients (23%) required 137 SIs. At 5 years, freedom from any SI was 64%±4%, including freedom from minor SIs of 77%±4% and major SIs of 87%±3%. There was no difference in patient survival and freedom from ARM at same interval. On adjusted analysis, minor SIs correlated with improved survival. SIs had a negative correlation with PCS ( r =-0.8). There were no significant changes in mental component score with SIs. Predictors for SIs were fluoroscopy time, graft design, and aneurysm sac change.CONCLUSION:
SIs were needed in nearly 1 out of 4 patients treated by FB-EVAR with no effect on patient survival or ARM. SI resulted in decline in PCS.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Aneurisma Aórtico
/
Aneurisma da Aorta Torácica
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Aneurisma da Aorta Abdominal
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Implante de Prótese Vascular
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Procedimentos Endovasculares
/
Aneurisma da Aorta Toracoabdominal
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Aged80
/
Humans
/
Male
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2023
Tipo de documento:
Article