scholarly journals Editor's Choice – Hospital Incidence, Treatment, and In Hospital Mortality Following Open and Endovascular Surgery for Thoraco-abdominal Aortic Aneurysms in Germany from 2005 to 2014: Secondary Data Analysis of the Nationwide German DRG Microdata

2019 ◽  
Vol 57 (4) ◽  
pp. 488-498 ◽  
Author(s):  
Sarah Geisbüsch ◽  
Andreas Kuehnl ◽  
Michael Salvermoser ◽  
Benedikt Reutersberg ◽  
Matthias Trenner ◽  
...  
Keyword(s):  
Data Analysis ◽  
Hospital Mortality ◽  
Secondary Data ◽  
Abdominal Aortic Aneurysms ◽  
Secondary Data Analysis ◽  
Endovascular Surgery ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

Complications of endovascular surgery for abdominal aortic aneurysms

2004 ◽  
Vol 61 (2) ◽  
pp. 163-165 ◽  
Author(s):  
Marcus D'Ayala ◽  
JonathanS Deitch ◽  
Leslie Wise
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Endovascular Surgery ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

scholarly journals Endovascular repair of thoraco-abdominal aortic aneurysms by fenestrated and branched endografts†

2019 ◽  
Vol 56 (5) ◽  
pp. 993-1000 ◽  
Author(s):  
Enrico Gallitto ◽  
Gianluca Faggioli ◽  
Rodolfo Pini ◽  
Chiara Mascoli ◽  
Stefano Ancetti ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Hospital Mortality ◽  
Endovascular Repair ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
The Mean ◽  
Aneurysm Repair

Abstract OBJECTIVES Our objective was to report the outcomes of fenestrated/branched endovascular aneurysm repair of thoraco-abdominal aortic aneurysms (TAAAs) with endografts. METHODS Between January 2010 and April 2018, patients with TAAAs, considered at high surgical risk for open surgery and treated by Cook-Zenith fenestrated/branched endovascular aneurysm repair, were prospectively enrolled and retrospectively analysed. The early end points were 30-day/hospital mortality rate, spinal cord ischaemia and 30-day cardiopulmonary and nephrological morbidity. Follow-up end points were survival, patency of target visceral vessels and freedom from reinterventions. RESULTS Eighty-eight patients (male: 77%; mean age: 73 ± 7 years; American Society of Anesthesiologists 3/4: 58/42%) were enrolled. Using Crawford’s classification, 43 (49%) were types I–III and 45 (51%) were type IV TAAAs. The mean aneurysm diameter was 65 ± 15 mm. Custom-made and off-the-shelf endografts were used in 60 (68%) and 28 (32%) cases, respectively. Five (6%) patients had a contained ruptured TAAA. The procedure was performed in multiple steps in 42 (48%) cases. There was 1 (1%) intraoperative death. Five (6%) patients suffered spinal cord ischaemia with permanent paraplegia in 3 (3%) cases. Postoperative cardiac and pulmonary complications occurred in 7 (8%) and 12 (14%) patients, respectively. Worsening of renal function (≥30% of baseline level) was detected in 11 (13%) cases, and 2 (2%) patients required haemodialysis. The 30-day and hospital mortality rates were 5% and 8%, respectively. The mean follow-up was 36 ± 22 months. Survival at 12, 24 and 36 months was 89%, 75% and 70%, respectively. The patency of target visceral vessels at 12, 24 and 36 months was 92%, 92% and 92%, respectively. Freedom from reinterventions at 12, 24 and 36 months was 85%, 85% and 83%, respectively. CONCLUSIONS The endovascular repair of TAAAs with fenestrated/branched endovascular aneurysm repair is feasible and effective with acceptable technical/clinical outcomes at early/midterm follow-up.

scholarly journals Regional variation in endovascular treatment rate and in-hospital mortality of abdominal aortic aneurysms in Germany

VASA ◽  
2020 ◽  
Vol 49 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Matthias Trenner ◽  
Michael Salvermoser ◽  
Benedikt Reutersberg ◽  
Albert Busch ◽  
Volker Schmid ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Patient Characteristics ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Treatment Rate ◽  
Abdominal Aortic ◽  
Regional Location ◽  
Using Data ◽  
Procedure Codes ◽  
Selection Of

Summary: Background: Abdominal aortic aneurysms (AAA) can be treated by either open surgery (OAR) or endovascular aortic repair (EVAR). The aim of this study was to analyze regional variations in application of (EVAR) and in-hospital mortality after intact AAA (iAAA) repair. Methods: Using data provided by the German Federal Statistical Office, a nationwide analysis for 2012 to 2014 was conducted. Patients with a diagnosis of iAAA (I71.4) and corresponding procedure codes for OAR (5-384.5/7) or EVAR (5-38a.1) were included. Odds ratios (ORs) for use of EVAR (proportion of EVAR among total EVAR + OAR cases) and mortality were calculated for all regions in Germany. ORs for EVAR use were adjusted for age, sex, and risk (Elixhauser score). ORs for mortality were additionally adjusted for type of procedure (OAR/EVAR). Results: Finally, 31,757 procedures for iAAA were included. Median age of all patients was 73 years (interquartile range 67–78 years) and 87.1 % were male. The mean proportion of EVAR procedures was 72.6 %; however, the application of EVAR for repair of iAAA varied widely depending on region. The lowest unadjusted regional rate of EVAR use was 48.8 %, while the highest was 92.5 %. After adjustment, the lowest regional OR for EVAR use (compared to the nationwide mean) was 0.23 (95 % confidence interval [0.15–0.36]), the highest 5.93 [1.79–19.65]. Overall in-hospital mortality was 2.9 % (OAR 6.2 %; EVAR 1.7 %). The adjusted regional OR for mortality ranged from 0.31 [0.07–1.42] to 4.98 [2.08–11.93]. Conclusions: This study reveals variations in use of EVAR and in-hospital mortality for iAAA treatment in Germany. This may imply that selection of treatment might not only be influenced by patient characteristics, but also by regional location. These results need to be taken into account when discussing centralization of AAA treatment in Germany.

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