Document Detail


Risk-adjusted outcome analysis of endovascular abdominal aortic aneurysm repair in a large population: how do stent-grafts compare?
MedLine Citation:
PMID:  16048373     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article    
Journal Detail:
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:
Created Date:  2005-07-28     Completed Date:  2005-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-29     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. c.vanmarrewijk@mdl.umcn.nl
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MeSH Terms
Descriptor/Qualifier:
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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