BACKGROUND: To determine whether patient adherence to follow-up and patient outcomes after endovascular aneurysm repair (EVAR) are affected by the distance between a patient's residence and a tertiary care treatment center. METHODS: A retrospective review of 136 consecutive patients undergoing EVAR at the New Mexico Veterans Affairs Medical Center over a 7-year period was conducted. Patients were stratified as living within a 100-mi radius of the treatment center (group 1) and those living outside this radius (group 2). Follow-up included clinic visits and computed tomography scans at 1 month after discharge, every 6 months for 2 years, and then yearly. Incomplete follow-up was defined if two or more consecutive appointments were missed. Survival and graft-related complication rates were analyzed for both the patient groups. RESULTS: Of the 136 patients, 10 patients died from nonaneurysm-related causes less than 1 year after their EVAR procedures, and hence were not a part of the study. Of the surviving patients, 44% lived within a 100-mi radius of the treatment center (group 1), and 56% outside this 100-mi radius (group 2). The mean patient follow-up time was 52.1 ± 25.9 months. Of the surviving patients, 15% had inadequate follow-up, yet there was no significant difference in the adequacy of follow-up for patients in group 1 compared with group 2. The incidence of major complications, defined as aneurysm rupture, conversion to open repair, myocardial infarction, and stroke, was not statistically different in group 1 versus group 2 (5.0% vs. 11.8%, p = 0.23). Of the five patients (3.7%) who died as a result of abdominal aortic aneurysms related causes, three were in group 1 and two in group 2. CONCLUSIONS: Distance from a tertiary care center is not a limiting factor in patient adherence to follow-up, patient graft-related morbidity, or patient survival, likely because of the Albuquerque VA Medical Center's electronic tracking of patients and provision of travel vouchers.
BACKGROUND: To determine whether patient adherence to follow-up and patient outcomes after endovascular aneurysm repair (EVAR) are affected by the distance between a patient's residence and a tertiary care treatment center. METHODS: A retrospective review of 136 consecutive patients undergoing EVAR at the New Mexico Veterans Affairs Medical Center over a 7-year period was conducted. Patients were stratified as living within a 100-mi radius of the treatment center (group 1) and those living outside this radius (group 2). Follow-up included clinic visits and computed tomography scans at 1 month after discharge, every 6 months for 2 years, and then yearly. Incomplete follow-up was defined if two or more consecutive appointments were missed. Survival and graft-related complication rates were analyzed for both the patient groups. RESULTS: Of the 136 patients, 10 patients died from nonaneurysm-related causes less than 1 year after their EVAR procedures, and hence were not a part of the study. Of the surviving patients, 44% lived within a 100-mi radius of the treatment center (group 1), and 56% outside this 100-mi radius (group 2). The mean patient follow-up time was 52.1 ± 25.9 months. Of the surviving patients, 15% had inadequate follow-up, yet there was no significant difference in the adequacy of follow-up for patients in group 1 compared with group 2. The incidence of major complications, defined as aneurysm rupture, conversion to open repair, myocardial infarction, and stroke, was not statistically different in group 1 versus group 2 (5.0% vs. 11.8%, p = 0.23). Of the five patients (3.7%) who died as a result of abdominal aortic aneurysms related causes, three were in group 1 and two in group 2. CONCLUSIONS: Distance from a tertiary care center is not a limiting factor in patient adherence to follow-up, patient graft-related morbidity, or patient survival, likely because of the Albuquerque VA Medical Center's electronic tracking of patients and provision of travel vouchers.
Authors: Caitlin W Hicks; Devin S Zarkowsky; Ian C Bostock; David H Stone; James H Black; Jens Eldrup-Jorgensen; Philip P Goodney; Mahmoud B Malas Journal: J Vasc Surg Date: 2017-02-16 Impact factor: 4.268
Authors: Andrew D Morris; Joshua E Preiss; Samuel Ogbuchi; Shipra Arya; Yazan Duwayri; Thomas F Dodson; William D Jordan; Luke P Brewster Journal: Am Surg Date: 2017-08-01 Impact factor: 0.688
Authors: Ali F AbuRahma; Michael Yacoub; Stephen M Hass; Joseph AbuRahma; Albeir Y Mousa; L Scott Dean; Ravi Viradia; Patrick A Stone Journal: J Vasc Surg Date: 2016-01-09 Impact factor: 4.268
Authors: Matthew Joe Grima; Mourad Boufi; Martin Law; Dan Jackson; Kate Stenson; Benjamin Patterson; Ian Loftus; Matt Thompson; Alan Karthikesalingam; Peter Holt Journal: Eur J Vasc Endovasc Surg Date: 2018-01-05 Impact factor: 7.069