Evaluation of the expediency of the EVAR procedure for AAA patients in the MST Enschede over the past 15 years.

Rietbergen, M. (2014) Evaluation of the expediency of the EVAR procedure for AAA patients in the MST Enschede over the past 15 years. thesis, Medicine.

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Abstract

Introduction. The incidence of AAA is rising in the Western World. At this time there are two surgical treatments; an open procedure and an endovascular procedure (EVAR). This EVAR is being used in the MST Enschede for 15 years. Aim. Evaluation of the EVAR procedure in the MST Enschede for AAA patients for the last 15 years. Method. 514 patients were included. Their general health, risk factors and their aneurysm characteristics were researched. The patients were divided according to the following procedures; first based on the year of surgery (I, II, III & IV) and second on the prosthesis (AneuRx, Talent, Anaconda, and Endurant). The outcomes are hospital survival, hospital stay, overall survival, aneurysm free survival, reinterventions free survival and conversion free survival. These outcomes were compared with multivariate regression models. Results. The application of the EVAR procedure increased during the examined period from 20.8% in 1998 to 52.6% in 2013. In total 27 patients died in the hospital. After correction for confounders, group III (2006-2009) and the Anaconda have the highest hospital survival. The hospital stay decreased significant. The Endurant has the shortest hospital stay (median of 3.5) and the Talent the longest (6). After correction, the survival is the best for group IV (2010-2013). For the prosthesis, the AneuRx has the best survival and the Talent the worst. Overall, 32 patients had a serious adverse event (SAE). Group IV and the Endurant have the lowest risk on a SAE. The highest risk is for the Talent and the AneuRx. The risk on a reinterventions is the lowest for group III and the Endurant. The highest risk is for group I (1998-2001), IV and the Talent. Overall there have been 38 conversions. The highest risk on a conversion is in group IV and for the Talent. The Endurant has the lowest risk. Conclusion. The hospital stay decreased significant. The Talent prosthesis has the worst outcomes but these are not always significant. The prosthesis being used at the moment (Anaconda and Endurant) are showing good results.

Item Type:	Thesis (Thesis)
Supervisor name:	Geelkerken, Dr. R.H. and Meerwaldt, Dr. R. and MST Enschede Vascular Surgery Department
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:49
Last Modified:	25 Jun 2020 10:49
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1019

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