Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair

Detalhes bibliográficos
Autor(a) principal: Vanmaele, Alexander
Data de Publicação: 2025
Outros Autores: Rastogi, Vinamr, Oliveira-Pinto, José, ten Raa, Sander, van Rijn, Marie Josee E., Bastos Gonçalves, Frederico, de Bruin, Jorg L., Verhagen, Hence J.M.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Texto Completo: http://hdl.handle.net/10362/182057
Resumo: Publisher Copyright: © 2025 The Authors
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spelling Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm RepairAbdominal aortic aneurysmEndovascular aneurysm repairRisk predictionSurveillanceSurgeryCardiology and Cardiovascular MedicinePublisher Copyright: © 2025 The AuthorsObjective: The aim of this study was to evaluate and compare methods that identify patients at low risk of developing complications after endovascular aortic aneurysm repair (EVAR) and who would thus not require surveillance in the first post-operative years. Methods: This was a retrospective, single centre, cohort study including all patients after elective infrarenal EVAR with both immediate post-operative and one year computed tomography angiography (CTA) imaging. Patients were categorised by adherence to instructions for use (IFU), adequate seal, and absence of endoleak (method A1), and without high risk features (method A2) on the first post-operative CTA. Additionally, these patients were dichotomised based on aneurysm sac shrinkage at one year (> 5 mm maximum diameter reduction, method B). Outcomes were graft related adverse events and all cause death. Negative predictive value (NPV) was used to compare risk classifications. Results: Of 422 eligible patients, 297 underwent the required imaging for classification: 140 (47.1%) and 109 (36.7%) patients were classified as low risk based on methods A1 and A2, respectively, while 147 (49.5%) were assumed low risk based on method B. The five year cumulative incidence of adverse events in low risk patients according to method A1 was 14.7% (95% confidence interval [CI] 8.5 – 20.9%), similar to method A2 (16.1%, 95% CI 8.8 – 23.4%) and method B (15.4%, 95% CI 9.3 – 21.5%). The five year median NPV for adverse events for method A1 was 85.2% (95% CI 79.7 – 90.8%), comparable with method A2 (83.8%, 95% CI 76.9 – 90.3%; p = .37) and method B (84.7%, 95% CI 79.4 – 89.5%; p = .87). Significantly higher NPVs were found by combining method A1 or A2 with method B, with median values ≥ 95% up to four years after EVAR. The five year NPV for death did not differ between methods (five year NPVmethod A1, 81.7%, 95% CI 76.6 – 86.5%). Conclusion: Refraining from imaging in the first five years after EVAR in patients treated within IFU and with a favourable post-operative CTA would have failed to detect important complications at an early stage. It is proposed to combine the post-operative CTA with sac shrinkage at one year in order to stratify post-EVAR surveillance. No benefit was found in considering the high risk features suggested in the European Society for Vascular Surgery (ESVS) guidelines.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNVanmaele, AlexanderRastogi, VinamrOliveira-Pinto, Joséten Raa, Sandervan Rijn, Marie Josee E.Bastos Gonçalves, Fredericode Bruin, Jorg L.Verhagen, Hence J.M.2025-04-10T15:59:12Z2025-022025-02-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/182057eng1078-5884PURE: 114074325https://doi.org/10.1016/j.ejvs.2025.01.042info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-04-14T01:41:24Zoai:run.unl.pt:10362/182057Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T06:26:00.099431Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
title Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
spellingShingle Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
Vanmaele, Alexander
Abdominal aortic aneurysm
Endovascular aneurysm repair
Risk prediction
Surveillance
Surgery
Cardiology and Cardiovascular Medicine
title_short Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
title_full Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
title_fullStr Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
title_full_unstemmed Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
title_sort Single Centre Evaluation of the Proposal of the European Society for Vascular Surgery Abdominal Aortic Aneurysm Guidelines to Stratify Surveillance after Endovascular Aortic Aneurysm Repair
author Vanmaele, Alexander
author_facet Vanmaele, Alexander
Rastogi, Vinamr
Oliveira-Pinto, José
ten Raa, Sander
van Rijn, Marie Josee E.
Bastos Gonçalves, Frederico
de Bruin, Jorg L.
Verhagen, Hence J.M.
author_role author
author2 Rastogi, Vinamr
Oliveira-Pinto, José
ten Raa, Sander
van Rijn, Marie Josee E.
Bastos Gonçalves, Frederico
de Bruin, Jorg L.
Verhagen, Hence J.M.
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Vanmaele, Alexander
Rastogi, Vinamr
Oliveira-Pinto, José
ten Raa, Sander
van Rijn, Marie Josee E.
Bastos Gonçalves, Frederico
de Bruin, Jorg L.
Verhagen, Hence J.M.
dc.subject.por.fl_str_mv Abdominal aortic aneurysm
Endovascular aneurysm repair
Risk prediction
Surveillance
Surgery
Cardiology and Cardiovascular Medicine
topic Abdominal aortic aneurysm
Endovascular aneurysm repair
Risk prediction
Surveillance
Surgery
Cardiology and Cardiovascular Medicine
description Publisher Copyright: © 2025 The Authors
publishDate 2025
dc.date.none.fl_str_mv 2025-04-10T15:59:12Z
2025-02
2025-02-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/182057
url http://hdl.handle.net/10362/182057
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1078-5884
PURE: 114074325
https://doi.org/10.1016/j.ejvs.2025.01.042
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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