M Rousié1, V Douillez, S Arend, Ph Arend.
Abstract
BACKGROUND: We evaluated clinical outcomes of EVAR procedures at a low-volume center in Belgium. We also analyzed the time before endoleak appeared.
METHODS: We reviewed 77 EVAR procedures performed over 10 years in a low-volume center. Patients were reviewed at intervals of 1, 3, 6, 12, 24 and 36 months.
RESULTS: The deployment of the endograft was successful for 76 of the 77 patients (98.7%). Perioperative mortality was 1.3%. Cardiac infarctus was reported in 5.19% of patients, 1.3% suffered hematoma, 1.3% renal insufficiency, 7.8%-respiratory diseases, and 2.6% strokes. The mortality rate during the first postoperative year was 9% and none of these deaths were AAA related. One endograft thrombosis was reported (1.3%) and there were no cases of endograft migration. Type 1 endoleak occurred in 3.9% of patients, and Type 2 in 22.1%. No other type of endoleak was reported. The mean period before endoleak diagnosis was 9.8 months. Two patients needed to be re-operated for a Type 1 endoleak.
CONCLUSION: Performing EVAR procedures in a low-volume center did not increase morbidity and mortality risks. This is probably because the primary factor is the volume of procedures carried out by the surgeon, rather than the institution. EVAR follow-up is needed to diagnose endoleak, which can appear several months after. © Acta Chirurgica Belgica.
BACKGROUND: We evaluated clinical outcomes of EVAR procedures at a low-volume center in Belgium. We also analyzed the time before endoleak appeared.
METHODS: We reviewed 77 EVAR procedures performed over 10 years in a low-volume center. Patients were reviewed at intervals of 1, 3, 6, 12, 24 and 36 months.
RESULTS: The deployment of the endograft was successful for 76 of the 77 patients (98.7%). Perioperative mortality was 1.3%. Cardiac infarctus was reported in 5.19% of patients, 1.3% suffered hematoma, 1.3% renal insufficiency, 7.8%-respiratory diseases, and 2.6% strokes. The mortality rate during the first postoperative year was 9% and none of these deaths were AAA related. One endograft thrombosis was reported (1.3%) and there were no cases of endograft migration. Type 1 endoleak occurred in 3.9% of patients, and Type 2 in 22.1%. No other type of endoleak was reported. The mean period before endoleak diagnosis was 9.8 months. Two patients needed to be re-operated for a Type 1 endoleak.
CONCLUSION: Performing EVAR procedures in a low-volume center did not increase morbidity and mortality risks. This is probably because the primary factor is the volume of procedures carried out by the surgeon, rather than the institution. EVAR follow-up is needed to diagnose endoleak, which can appear several months after. © Acta Chirurgica Belgica.
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Mesh：
Year: 2015
PMID： 26763838 DOI： 10.1080/00015458.2015.11681141
Source DB: PubMed Journal: Acta Chir Belg ISSN： 0001-5458 Impact factor: 1.090