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. 2023 Sep 4:11:100522.
doi: 10.1016/j.ejro.2023.100522. eCollection 2023 Dec.

Exploiting endovascular aortic repair as a minimally invasive method - Nine years of experience in a non-university hospital

Lars Borgen  1 , Kjartan Aasekjær  1 , Øyvind Werpen Skoe  2
Affiliations

Exploiting endovascular aortic repair as a minimally invasive method - Nine years of experience in a non-university hospital

Lars Borgen et al. Eur J Radiol Open. .

Abstract

Background: At the introduction of endovascular aortic repair (EVAR) in 2013 in our non-university hospital, we established a quality registry to monitor our EVAR activity.

Purpose: To observe if we over time were able to exploit EVAR as a minimally invasive method in an elective as well as emergency setting, and to monitor our treatment quality in terms of complications, secondary interventions and mortality.

Material and methods: From November 2013 to March 2022, we treated 207 patients with EVAR, including six patients with rupture. Follow-up regimen was partly based on contrast-enhanced computer tomography, and partly on contrast-enhanced ultrasound in combination with plain radiography.

Results: During the observation period, the method of anesthesia changed from general, via spinal, to local anesthesia. The groin access changed from surgical cut down to percutaneous and the median length of postoperative stay decreased from 3 days to 1 day. EVAR on ruptured aneurysm was done for the first time in 2019. Endoleak was detected in 85 patients (42%) and 37 patients (18%) had one or more secondary interventions, of which 85% were endovascular. Estimated five-year survival was 72% in patients below 80 years of age and 45% in patients 80 years or older.

Conclusion: Nine years of experience enabled us to exploit EVAR's advantages as a minimally invasive method in an elective as well as emergency setting. Complications, secondary interventions and survival rates in our low volume non-university hospital matches results from larger vascular centers.

Keywords: Aneurysm; Aorta; Interventional; Vascular.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Method of analgesia during the observation period.
Fig. 2
Fig. 2
Vascular access during the observation period.
Fig. 3
Fig. 3
Postoperative length of stay for elective EVAR.
Fig. 4
Fig. 4
Estimated freedom from secondary interventions, Kaplan-Meyer diagram.
Fig. 5
Fig. 5
Estimated survival, Kaplan-Meyer diagram.
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