دورية أكاديمية
Long-Term Outcomes of Standard Endovascular Aneurysm Repair in Patients With Severe Neck Angulation
| العنوان: | Long-Term Outcomes of Standard Endovascular Aneurysm Repair in Patients With Severe Neck Angulation |
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| المؤلفون: | Oliveira, N, Bastos Gonçalves, F, Hoeks, S, Josee van Rijn, M, Ultee, K, Pinto, JP, Raa, S, van Herwaarden, J, de Vries, JP, Verhagen, H |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2018 |
| المجموعة: | Repositório do Centro Hospitalar de Lisboa Central EPE |
| مصطلحات موضوعية: | Aged, 80 and over, Aortic Aneurysm, Abdominal, Aortography, Blood Vessel Prosthesis, Computed Tomography Angiography, Databases, Factual, Endoleak, Female, Humans, Male, Middle Aged, Netherlands, Prosthesis Design, Retrospective Studies, Risk Factors, Stents, Time Factors, Treatment Outcome, Blood Vessel Prosthesis Implantation, Endovascular Procedures, HSM CIR VASC |
| الوصف: | Objective: Severe neck angulation is associated with complications after endovascular aneurysm repair (EVAR). Newer endografts may overcome this limitation, but the literature lacks long-term results. We studied the long-term outcomes of EVAR in patients with severe neck angulation. Methods: A retrospective case-control study of a prospective multicenter database was performed. All measurements were made with dedicated software with center lumen line reconstruction. A study group including patients with neck length >15 mm, infrarenal angle (β) >75 degrees or suprarenal angle (α) >60 degrees, and neck length 10 to 15 mm with β >60 degrees or α >45 degrees was compared with a control group matched for demographics and other morphologic neck features. The primary end point was type IA endoleak (EL1A). Secondary end points were freedom from neck-related secondary interventions, primary clinical success, and overall survival. Results: Forty-five patients were included in the angulated neck group and compared with 65 matched patients. Median follow-up was 7.4 years (interquartile range, 4.8-8.5 years). In the angulated neck group, mean α was 51.4 degrees (±21.1 degrees) and the mean β was 80.8 degrees (±15.6 degrees); in the nonangulated group, these were 17.9 degrees (±17.0 degrees) and 35.4 degrees (±20.0 degrees), respectively. At 7 years, five patients in the angulated neck group and two nonangulated patients developed EL1A, yielding a freedom from EL1A of 86.1% (n = 14; standard error [SE], 0.069) and 96.6% (n = 34; SE, 0.023), respectively (P = .056). After exclusion of a patient who developed an EL1A secondary to an endograft infection, this difference was significant: 86.1% (n = 14; SE, 0.069) in the angulated neck group and 98.2% (n = 34; SE, 0.018) in the nonangulated group (P = .016). At 7 years, freedom from neck-related secondary interventions was 91.7% (n = 14; SE, 0.059) and 91.6% (n = 29; SE, 0.029), respectively. The 7-year primary clinical success estimates were 41.2% (n = 11; SE, ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | J Vasc Surg. 2018 Dec;68(6):1725-1735.; http://hdl.handle.net/10400.17/3620Test |
| DOI: | 10.1016/j.jvs.2018.03.427 |
| الإتاحة: | https://doi.org/10.1016/j.jvs.2018.03.427Test http://hdl.handle.net/10400.17/3620Test |
| حقوق: | openAccess |
| رقم الانضمام: | edsbas.7CB341D7 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jvs.2018.03.427 |
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