Early outcomes of endovascular aneurysm repair for abdominal aortic aneurysm: first preliminary report of national hospital organization network study in Japan

Abstract

Patients and methods: In order to assess the early outcomes of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) in the Japanese population, a total of 183 patients who had EVAR at eight medical centers of the National Hospital Organization were retrospectively reviewed and registered. The mean number of registered cases in each center was 23 ± 17 (4-50 cases). Patient characteristics were male sex, 84%; mean age, 77 years; age ≥ 80 years, 40%.

Results: In-hospital mortality was one case (0.5%). Endoleaks were observed at the end of the procedure in 35 patients (19%: type I: n = 4, II: n = 22, III, n = 3, IV: n = 6). Early morbidity included delayed wound healing or infection (n = 7), deterioration of renal dysfunction (n = 3), stroke (n = 2), postoperative bleeding (n = 2), gastrointestinal complications (n = 2), and peripheral thromboembolism (n = 2). Eleven late deaths included one of unknown cause and six cardiovascular causes at a mean follow up of 1.0 year. Survival rates of freedom from all causes of death and from aneurysm-related death at one year were 95.4% ± 1.7% and 99.5% ± 0.5%, respectively.

Interpretation: Although registered patients carry a variety of risks, early outcomes were satisfactory. EVAR is an acceptable alternative treatment modality for treating AAA.

Keywords: Key words endovascular aneurysm repair; abdominal aortic aneurysm; multicenter study.

Fig. 1

Preoperative and postoperative physical performance index (PPI) of 129 patients whose data of both preoperative and postoperative grades were available.

Fig. 2

Kaplan-Meier survival analysis freedom from events. a: Survival curve freedom from all-cause death. b: Survival curve freedom from cardiovascular death. c: Survival curve freedom from aneurysm-related death.