Short and one-year outcome of endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAAs)

Abstract

BACKGROUND: Endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAAs) has been marked as standard practice during the past decades. We aimed to investigate the shortand long-term outcomes of EVAR in patients with AAAs in Isfahan, Iran. .METHODS: This retrospective study conducted on 50 patients with AAAs who have undergone EVAR procedure consequently in four different hospitals (Chamran hospital, Asgarieh hospital, Sepahan hospital and Saadi hospital) in Isfahan, Iran, between 2017 to 2020. We followed patients for one year and recorded short-term and one-year outcome include Endoleak, Aorta-iliac expansion, and mortality in hospital records during one year and telephone follow up. Data was entered in SPSS (ver.25) and analyzed with Univariate Linear Regression and Chi-Square Test.RESULTS: The mean age of participants was 66.6±11.7 years old, in which 88%(n=44) of them were male. Elective EVAR was performed in 88% of patients. Regarding the complications one year after EVAR, endoleak and CIN (contrast-induced nephropathy) were occurred in 6%(n=3) and 6%(n=3) of patients, respectively. We also reported the rate of in-hospital mortality and one-year mortality as 2%(n=1) and 8%(n=4), respectively. Univariate regression analysis revealed no significant difference regarding one-year mortality in patients who underwent EVAR. In patients who underwent spinal anesthesia in comparison with general and regional anesthesia before EVAR, there were lower rate of vascular complications [0% (n=0) versus 23.5% (n=4) and 20.0% (n=2), P=0.053], level of blood urea nitrogen (BUN) [9.8 ± 13.9 versus 17.0 ± 13.1 and 14 ± 6.2, P=0.031] and creatinine (Cr) [0.6±1.1 versus 1.1±0.6 and 1.3±0.5, P=0.005], respectively.CONCLUSION: Desirable short- and long-term outcomes as expected, combined with a reduction in hospital length of stay and mortality and one-year mortality allowed EVAR to become the favorable therapeutic strategy for AAAs in Iran especially in high-risk patients. Lower rate of vascular complications, ICU length of stay and lower level of BUN and Cr were observed using spinal anesthesia in patients who underwent EVAR in our centers.

Keywords

• abdominal aortic aneurysm
• endovascular aortic repair
• treatment outcome