Turkish Journal of Vascular Surgery (Mar 2021)
Can endovascular repair be the first-line treatment option in abdominal aortic aneurysms during COVID-19 pandemic?
Abstract
Objectives: This study aims to investigate the effectiveness of endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: A total of 22 patients (17 males, 5 females; mean age: 76.7±7.1 years; range, 66 to 90 years) who underwent EVAR for AAAs in our center between March 2020 and December 2020 were retrospectively analyzed. All patients underwent reverse transcriptasepolymerase chain reaction (RT-PCR) for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. All EVAR procedures were performed under spinal anesthesia in the elective setting in the angiography laboratory. Results: The RT-PCR test result was positive in six patients with asymptomatic infection. The mean AAA diameter was 74.7±5.5 (range, 68.50 to 85.60) mm. Stent-graft implantation was successfully performed in all patients. There was no significant relationship between the mean age and examined variables (p>0.050). The mean AAA diameter was 83.95 mm in the COVID-19-positive patients and 71.50 mm in the COVID-19-negative patients, indicating a significant difference (p=0.001). No mortality, stent migration or thrombotic events were observed during the first 30 days of follow-up. Conclusion: The operation can be delayed in patients requiring open surgical repair or in those with small AAAs. Based on our findings, the EVAR can be used as the first-line treatment option during the pandemic, as it does not require intubation and requires a low number of staff and is cost-effective with minimum necessity for intensive care unit stay and less use of healthcare resources. [Turk J Vasc Surg 2021; 30(2.000): 107-14]
