| Risk-adjusted outcome analysis of endovascular abdominal aortic aneurysm repair in a large population: how do stent-grafts compare? | |
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MedLine Citation:
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PMID: 16048373 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To compare differences in the applicability and incidence of postoperative adverse events among stent-grafts used for repair of infrarenal aortic aneurysms. METHODS: An analysis of 6787 patients from the EUROSTAR Registry database was conducted to compare aneurysm morphological features, patient characteristics, and postoperative events for the AneuRx, EVT/Ancure, Excluder, Stentor, Talent, and Zenith devices versus the Vanguard device (control) and each other. Annual incidence rates of complications were determined, and risks were compared using the Cox proportional hazards analysis. RESULTS: The annual incidence rates were: device-related endoleak (types I and III) 6% (range 4%-10%), type II endoleak 5% (range 0.3%-11%), migration 3% (range 0.5%-5%), kinking 2% (range 1%-5%), occlusion 3% (range 1%-5%), rupture 0.5% (range 0%-1%), and all-cause mortality 7% (range 5%-8%). After adjustment for factors influencing outcome, AneuRx, Excluder, Talent, and Zenith devices were associated with a lower risk of migration, kinking, occlusion, and secondary intervention compared to the Vanguard device. Significant increased risk for conversion (EVT/Ancure) and reduced risk of aneurysm rupture (AneuRx and Zenith) and all-cause mortality (Excluder) were found compared to the Vanguard device. CONCLUSIONS: Significant differences exist between stent-grafts of different labels in terms of applicability and complications during intermediate to long-term follow-up. Since each stent-graft has its drawbacks, no single label can be identified as the best. It is reassuring that developments in stent-grafts indeed result in better performance than the early stent-grafts. However, a single device incorporating all the perceived improvements should still be pursued. |
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Authors:
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Corine J van Marrewijk; Lina J Leurs; Srinivasa R Vallabhaneni; Peter L Harris; Jacob Buth; Robert J F Laheij; |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists Volume: 12 ISSN: 1526-6028 ISO Abbreviation: J. Endovasc. Ther. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-07-28 Completed Date: 2005-11-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 417-29 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. c.vanmarrewijk@mdl.umcn.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Distribution Aged Aged, 80 and over Aneurysm, Ruptured / mortality, radiography, surgery* Aortic Aneurysm, Abdominal / mortality, radiography, surgery* Blood Vessel Prosthesis* Blood Vessel Prosthesis Implantation / adverse effects*, methods Cohort Studies Female Follow-Up Studies Great Britain / epidemiology Humans Incidence Male Middle Aged Postoperative Complications / mortality* Probability Prosthesis Design Prosthesis Failure Registries Risk Assessment Sex Distribution Stents Survival Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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