PMID- 32144013
OWN - NLM
STAT- MEDLINE
DCOM- 20201130
LR  - 20201130
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 72
IP  - 2
DP  - 2020 Aug
TI  - Treatment choice and survival after ruptured abdominal aortic aneurysm: A 
      population-based study.
PG  - 508-517.e11
LID - S0741-5214(20)30115-4 [pii]
LID - 10.1016/j.jvs.2019.11.060 [doi]
AB  - OBJECTIVE: The objective of this study was to clarify whether the findings of the 
      randomized studies of repair method (open aortic repair [OAR] vs endovascular 
      aneurysm repair [EVAR]) concerning short-term and midterm survival for ruptured 
      abdominal aortic aneurysms (RAAAs) could be confirmed in a contemporary, 
      nationwide, and unselected population. METHODS: This cohort study is based on 
      prospectively collected data from Swedvasc, a nationwide vascular registry, 
      including all 29 hospitals performing surgery for RAAA in Sweden (3 district, 19 
      county, and 7 university hospitals) during 2013 to 2015. All 702 patients 
      operated on for RAAA during this time were included. Open surgery and 
      endovascular repair, analyzed on the basis of individual patient repair (OAR vs 
      EVAR) and hospital repair practice (OAR-only vs OAR/EVAR), were compared for 
      short-term and midterm adjusted survival (0-90 days and 3 months-3 years). 
      RESULTS: Endovascular repair was used for 37% (260/702) of the aneurysms. The 
      adjusted hazard ratio after OAR was 1.30 (0.95-1.77; P = .098; n = 702) for 0 to 
      90 days and 0.63 (0.43-0.93; P = .021; n = 491) for 3 months to 3 years of 
      follow-up compared with EVAR. The adjusted hazard ratio for a practice of 
      OAR-only was 0.73 (0.54-1.00; P = .047; n = 702) for 0 to 90 days and 0.68 
      (0.45-1.05; P = .080; n = 491) for 3 months to 3 years of follow-up compared with 
      a practice of OAR/EVAR. No interaction between repair practice and short-term 
      survival could be shown for either sex or age. CONCLUSIONS: An OAR/EVAR practice 
      for RAAA is not superior to an OAR-only practice with respect to survival at 
      short-term or midterm follow-up. The results are even compatible with an 
      advantage of OAR-only practice vs OAR/EVAR practice for both follow-up periods. 
      There is no extra benefit for either female or elderly patients with an OAR/EVAR 
      practice.
CI  - Copyright (c) 2020 Society for Vascular Surgery. Published by Elsevier Inc. All 
      rights reserved.
FAU - Lundgren, Fredrik
AU  - Lundgren F
AD  - Department of Surgery, County Hospital, Kalmar, Sweden; Division of 
      Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of 
      Health Sciences, Linkoping University, Linkoping, Sweden. Electronic address: 
      fredrik.bg.lundgren@gmail.com.
FAU - Troeng, Thomas
AU  - Troeng T
AD  - Centre for Quality Registries South/Karlskrona, Blekinge Hospital, Karlskrona, 
      Sweden; Department of Surgical Sciences, Vascular Surgery, Uppsala University, 
      Uppsala, Sweden.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20200303
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
CIN - J Vasc Surg. 2020 Aug;72(2):387-388. PMID: 32711903
CIN - J Vasc Surg. 2020 Aug;72(2):518-519. PMID: 32711906
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnostic imaging/mortality/*surgery
MH  - Aortic Rupture/diagnostic imaging/mortality/*surgery
MH  - *Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - Clinical Decision-Making
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - Female
MH  - Humans
MH  - Male
MH  - Patient Selection
MH  - Postoperative Complications/mortality
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sweden
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cohort study
OT  - Endovascular aortic repair (EVAR)
OT  - Open aortic repair (OAR)
OT  - Ruptured abdominal aortic aneurysm (RAAA)
OT  - Survival
EDAT- 2020/03/08 06:00
MHDA- 2020/12/01 06:00
CRDT- 2020/03/08 06:00
PHST- 2019/07/17 00:00 [received]
PHST- 2019/11/13 00:00 [accepted]
PHST- 2020/03/08 06:00 [pubmed]
PHST- 2020/12/01 06:00 [medline]
PHST- 2020/03/08 06:00 [entrez]
AID - S0741-5214(20)30115-4 [pii]
AID - 10.1016/j.jvs.2019.11.060 [doi]
PST - ppublish
SO  - J Vasc Surg. 2020 Aug;72(2):508-517.e11. doi: 10.1016/j.jvs.2019.11.060. Epub 
      2020 Mar 3.