Document Detail


Improved survival after endoluminal repair with second-generation prostheses compared with open repair in the treatment of abdominal aortic aneurysms: a 5-year concurrent comparison using life table method.
MedLine Citation:
PMID:  11174808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to compare the outcome of consecutive patients with abdominal aortic aneurysm (AAA) treated concurrently by means of open repair (OR) and endoluminal repair (ER) with second-generation prostheses by the same surgeons during a defined interval.
METHODS: Between May 1995 and December 1998 second-generation (low profile, fully supported, modular) endoprostheses were implanted in 148 patients. These patients, together with 135 patients treated concurrently with OR during the same period, comprised the study group of 283 patients. Patient selection was based on aneurysm morphology. Those patients who were anatomically suitable for ER were treated with this method. The ER and OR groups were similar with regard to age, sex, and size of AAA. The ER group contained high-risk patients considered unfit for OR (n = 46), and the OR group contained high-risk patients who were anatomically unsuitable for ER (n = 19). Outcome criteria in both groups were survival and successful aneurysm repair. Success in the ER group was defined as exclusion of the aneurysm sac and stability or reduction in AAA maximum transverse diameter. Persistent endoleaks were classified as failures, regardless of whether they were subsequently corrected with secondary endovascular intervention. Data were analyzed with the life table method. The minimum period of follow-up for all patients was 18 months.
RESULTS: The perioperative mortality rate was 5.9% in the OR group and 2.7% in the ER group (not significant). There was a statistically significant difference between the survival curves of the two groups in favor of the ER group when analyzed with the log-rank test (P =.004). The Kaplan-Meier curve for graft failure for the ER group revealed a 3-year graft success probability of 82%. Survival probability with successful repair in the OR group at 3 years was 85%.
CONCLUSIONS: A concurrent comparison of ER with second-generation prostheses versus OR demonstrated a significant difference in survival in favor of the ER group. The probability of survival with successful repair at 3 years was similar in both groups.
Authors:
J May; G H White; R Waugh; C N Ly; M S Stephen; M A Jones; J P Harris
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  33     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-22     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S21-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Sydney, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty / adverse effects,  instrumentation*,  mortality*
Aortic Aneurysm, Abdominal / complications,  mortality*,  radiography,  surgery*
Aortography
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  mortality*
Comorbidity
Female
Follow-Up Studies
Humans
Life Tables
Male
Patient Selection
Proportional Hazards Models
Prosthesis Design
Prosthesis Failure
Risk Factors
Survival Analysis
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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