Sakarya Tıp Dergisi (Mar 2020)

Factors Affecting Mortality and Morbidity After Endovascular Aortic Repair for Abdominal Aortic Aneurysms

  • Hakan Saçlı,
  • İbrahim Kara

DOI
https://doi.org/10.31832/smj.645571
Journal volume & issue
Vol. 10, no. 1
pp. 65 – 73

Abstract

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Objective: Endovascular aortic repair (EVAR) has been preferred increasingly surgical repair for abdominal aortic aneurysms (AAAs). This minimally invasive procedure has favorable effects in the early period but our purpose is to reveal the anatomical and non-anatomical risk factors affecting mortality and morbidity after EVAR in the prolonged period.Materials and Methods: A total of 96 patients ( 91m, 5 f) electively EVAR operated for infrarenal AAAs between September 2014 to January 2019 is included to the study. Preoperative and postoperative computed tomography (CT) scans is controlled periodly and determined individually. Demographic factors, anatomical properties of the AAAs and non-anatomical risk factors are assessed. Kaplan-Meier survival analysis was used to determine survival rates. Cox regression and hazard ratio (HR) was used to assess the relation of these determined factors on mortality and morbidity.Results: Mean follow up time was 27,45 ± 12,99 months. We found that aortic neck morphology has an statistically significant effect on mortality (p value: 0.046 and HR: 1,73 [ 1,01-2,96]). Aortic neck angle, cigarette smoking, obesity, Peripheral artery disease(PAD), coronary artery disease, chronic obstructive pulmonary disease have an increased hazard ratio on mortality ( HR in order; 1,39; 1,45; 3,33; 1,84; 1,87; 3,60). Increased creatinine level (p value: 0.003), precence of chronic renal failure (p value: 0.013)and diabetes mellitus (p value: 0.038) have an statistically significant negative effect on morbidity. Obesity and PAD have an increased hazard ratio on morbidity(HR in order; 4,58; 1,61). Conclusion: This study showed us survival after EVAR procedure is connected with several pre and postoperative factors. Preoperative datailed evaluation for the anatomical properties of aneurysm is important to achieve prolonged benefit and postoperative follow up is crucial.

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