PMID- 32138625
OWN - NLM
STAT- MEDLINE
DCOM- 20200629
LR  - 20220413
IS  - 1938-9116 (Electronic)
IS  - 1538-5744 (Linking)
VI  - 54
IP  - 4
DP  - 2020 May
TI  - Perioperative Outcomes for Abdominal Aortic Aneurysm Repair Based on Aneurysm 
      Diameter.
PG  - 341-347
LID - 10.1177/1538574420909635 [doi]
AB  - BACKGROUND: Guidelines from the Society for Vascular Surgery recommend elective 
      repair in asymptomatic patients with an abdominal aortic aneurysm (AAA) only if 
      their diameter is greater than or equal to 5.5 cm, yet smaller ones are routinely 
      repaired. This study aims to evaluate perioperative outcomes based on aneurysm 
      size at the time of repair. METHODS: Male patients who underwent elective 
      endovascular aneurysm repair (EVAR) or open abdominal aneurysm repair (OAAR) 
      repair of an infrarenal AAA were abstracted from 2011 to 2015 Targeted National 
      Surgical Quality Improvement Program (NSQIP) database. Patients with symptoms or 
      with aneurysmal extension into the visceral or iliac vessels were excluded. 
      Outcomes of open versus endovascular repair were reported, with multivariate 
      analyses to identify factors associated with the decision to repair AAA </=5.4 cm. 
      RESULTS: A total of 2115 (90.9%) patients underwent EVAR, while 213 (9.1%) 
      underwent OAAR. The mean diameter in patients who underwent OAAR was 6.1 cm 
      (interquartile range [IQR]: 5.2-6.1 cm) versus 5.7 cm (IQR: 5.2-6.0 cm) for EVAR. 
      However, in 42.5% of EVAR and 32.8% of OAAR patients, the diameter of the AAA was 
      5.4 cm or less. The group undergoing repair of AAA </=5.4 cm was younger compared 
      to the larger AAA group (71.9 vs 73.9 years; P < .0001). Patients older than 80 
      years were less likely to have a repair of AAA measuring </=5.4 cm (odds ratio [OR] 
      = 0.45, 95% confidence interval [CI] = 0.30-0.65). Additionally, patients who 
      underwent EVAR were more likely to have AAA measuring </=5.4 cm repaired compared 
      to those who underwent OAAR (OR = 1.62, 95% CI = 1.19-2.21). There were no 
      differences in perioperative morbidity or mortality between the groups. 
      CONCLUSION: There were no differences in perioperative outcomes after AAA repair, 
      independent of aneurysm diameter. We found a higher likelihood of repairing AAA 
      </=5.4 cm in younger patients who were more likely to have been repaired with EVAR. 
      Patients older than 80 years were less likely to undergo small AAA repair.
FAU - Ramos, Christopher
AU  - Ramos C
AD  - Division of Vascular Surgery and Endovascular Therapy, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Pujari, Amit
AU  - Pujari A
AUID- ORCID: 0000-0002-7615-2508
AD  - Emory University School of Medicine, Atlanta, GA, USA.
FAU - Rajani, Ravi R
AU  - Rajani RR
AUID- ORCID: 0000-0001-6839-6011
AD  - Division of Vascular Surgery and Endovascular Therapy, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Escobar, Guillermo A
AU  - Escobar GA
AD  - Division of Vascular Surgery and Endovascular Therapy, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Rubin, Brian G
AU  - Rubin BG
AD  - Section of Vascular Surgery, Department of Surgery, Washington University School 
      of Medicine in St. Louis, Saint Louis, MO, USA.
FAU - Jordan, William D Jr
AU  - Jordan WD Jr
AD  - Division of Vascular Surgery and Endovascular Therapy, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Benarroch-Gampel, Jaime
AU  - Benarroch-Gampel J
AD  - Division of Vascular Surgery and Endovascular Therapy, Emory University School of 
      Medicine, Atlanta, GA, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20200306
PL  - United States
TA  - Vasc Endovascular Surg
JT  - Vascular and endovascular surgery
JID - 101136421
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/mortality/*surgery
MH  - Asymptomatic Diseases
MH  - *Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - Databases, Factual
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/mortality
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
OTO - NOTNLM
OT  - AAA
OT  - EVAR
OT  - diameter
OT  - repair
EDAT- 2020/03/07 06:00
MHDA- 2020/07/01 06:00
CRDT- 2020/03/07 06:00
PHST- 2020/03/07 06:00 [pubmed]
PHST- 2020/07/01 06:00 [medline]
PHST- 2020/03/07 06:00 [entrez]
AID - 10.1177/1538574420909635 [doi]
PST - ppublish
SO  - Vasc Endovascular Surg. 2020 May;54(4):341-347. doi: 10.1177/1538574420909635. 
      Epub 2020 Mar 6.