Skip to main content
Erschienen in: Heart and Vessels 2/2013

01.03.2013 | Original Article

Candidates and major determinants for endovascular repair of abdominal aortic aneurysms in Korean patients

verfasst von: Joo Myung Lee, Cheong Lim, Tae-Jin Youn, Eun Ju Chun, Sang-Il Choi, Young-Seok Cho, Goo-Yeong Cho, In-Ho Chae, Kay-Hyun Park, Dong-Ju Choi

Erschienen in: Heart and Vessels | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

The purpose of this study was to determine what proportion of patients with an abdominal aortic aneurysm (AAA) would be eligible for endovascular aneurysm repair (EVAR) and to examine the major determinants for suitability of EVAR with the currently available indications. We retrospectively reviewed 3-D reconstructed computed tomography angiography of 88 patients with an atherosclerotic AAA who underwent open repair or EVAR between October 2003 and October 2010 at the Cardiovascular Center, Seoul National University Bundang Hospital. Of the 88 patients, 71 (80.7%) were treated with open repair and 17 (19.3%) were treated with EVAR. The rate of minor complications, postprocedural intensive care unit stay, and total hospital stay were significantly lower in the EVAR group. When the suitability of EVAR was reevaluated using morphologic criteria, a total of 33 (37.5%) patients were considered eligible for EVAR. Multivariate analysis revealed that proximal neck length, proximal neck angle, and aneurismal sac size were independent determinants for suitability of EVAR. Taking into account the increased clinical experience and the availability of new devices, EVAR would be applicable in about 40% of atherosclerotic AAA cases in this series of Korean patients. Accurate identification of candidates for EVAR by detailed preoperative evaluation, especially for morphologic characteristics, is essential.
Literatur
1.
Zurück zum Zitat Melton LJ 3rd, Bickerstaff LK, Hollier LH, Van Peenen HJ, Lie JT, Pairolero PC, Cherry KJ, O’Fallon WM (1984) Changing incidence of abdominal aortic aneurysms: a population-based study. Am J Epidemiol 120(3):379–386PubMed Melton LJ 3rd, Bickerstaff LK, Hollier LH, Van Peenen HJ, Lie JT, Pairolero PC, Cherry KJ, O’Fallon WM (1984) Changing incidence of abdominal aortic aneurysms: a population-based study. Am J Epidemiol 120(3):379–386PubMed
2.
Zurück zum Zitat Poon JT, Cheng SW, Wong JS, Ting AC (2010) Prevalence of abdominal aortic aneurysm in Chinese patients with severe coronary artery disease. ANZ J Surg 80(9):630–633PubMedCrossRef Poon JT, Cheng SW, Wong JS, Ting AC (2010) Prevalence of abdominal aortic aneurysm in Chinese patients with severe coronary artery disease. ANZ J Surg 80(9):630–633PubMedCrossRef
3.
Zurück zum Zitat Cheng SW, Ting AC, Tsang SH (2003) Epidemiology and outcome of aortic aneurysms in Hong Kong. World J Surg 27(2):241–245PubMed Cheng SW, Ting AC, Tsang SH (2003) Epidemiology and outcome of aortic aneurysms in Hong Kong. World J Surg 27(2):241–245PubMed
4.
Zurück zum Zitat Yii MK (2003) Epidemiology of abdominal aortic aneurysm in an Asian population. ANZ J Surg 73(6):393–395PubMedCrossRef Yii MK (2003) Epidemiology of abdominal aortic aneurysm in an Asian population. ANZ J Surg 73(6):393–395PubMedCrossRef
5.
Zurück zum Zitat The UK Small Aneurysm Trial Participants (1998) Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet 352(9141):1649–1655 The UK Small Aneurysm Trial Participants (1998) Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet 352(9141):1649–1655
6.
Zurück zum Zitat Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, Ballard DJ, Messina LM, Gordon IL, Chute EP, Krupski WC, Busuttil SJ, Barone GW, Sparks S, Graham LM, Rapp JH, Makaroun MS, Moneta GL, Cambria RA, Makhoul RG, Eton D, Ansel HJ, Freischlag JA, Bandyk D (2002) Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 346(19):1437–1444PubMedCrossRef Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, Ballard DJ, Messina LM, Gordon IL, Chute EP, Krupski WC, Busuttil SJ, Barone GW, Sparks S, Graham LM, Rapp JH, Makaroun MS, Moneta GL, Cambria RA, Makhoul RG, Eton D, Ansel HJ, Freischlag JA, Bandyk D (2002) Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 346(19):1437–1444PubMedCrossRef
7.
Zurück zum Zitat Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, van Herwaarden JA, Holt PJ, van Keulen JW, Rantner B, Schlosser FJ, Setacci F, Ricco JB (2011) Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg 41(Suppl 1):S1–S58 Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, van Herwaarden JA, Holt PJ, van Keulen JW, Rantner B, Schlosser FJ, Setacci F, Ricco JB (2011) Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg 41(Suppl 1):S1–S58
8.
Zurück zum Zitat Hallett JW Jr, Marshall DM, Petterson TM, Gray DT, Bower TC, Cherry KJ Jr, Gloviczki P, Pairolero PC (1997) Graft-related complications after abdominal aortic aneurysm repair: reassurance from a 36-year population-based experience. J Vasc Surg 25(2):277–284PubMedCrossRef Hallett JW Jr, Marshall DM, Petterson TM, Gray DT, Bower TC, Cherry KJ Jr, Gloviczki P, Pairolero PC (1997) Graft-related complications after abdominal aortic aneurysm repair: reassurance from a 36-year population-based experience. J Vasc Surg 25(2):277–284PubMedCrossRef
9.
Zurück zum Zitat Conrad MF, Crawford RS, Pedraza JD, Brewster DC, Lamuraglia GM, Corey M, Abbara S, Cambria RP (2007) Long-term durability of open abdominal aortic aneurysm repair. J Vasc Surg 46(4):669–675PubMedCrossRef Conrad MF, Crawford RS, Pedraza JD, Brewster DC, Lamuraglia GM, Corey M, Abbara S, Cambria RP (2007) Long-term durability of open abdominal aortic aneurysm repair. J Vasc Surg 46(4):669–675PubMedCrossRef
10.
Zurück zum Zitat Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, Buskens E, Grobbee DE, Blankensteijn JD (2004) A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 351(16):1607–1618PubMedCrossRef Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, Buskens E, Grobbee DE, Blankensteijn JD (2004) A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 351(16):1607–1618PubMedCrossRef
11.
Zurück zum Zitat Lederle FA, Freischlag JA, Kyriakides TC, Padberg FT Jr, Matsumura JS, Kohler TR, Lin PH, Jean-Claude JM, Cikrit DF, Swanson KM, Peduzzi PN (2009) Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA 302(14):1535–1542PubMedCrossRef Lederle FA, Freischlag JA, Kyriakides TC, Padberg FT Jr, Matsumura JS, Kohler TR, Lin PH, Jean-Claude JM, Cikrit DF, Swanson KM, Peduzzi PN (2009) Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA 302(14):1535–1542PubMedCrossRef
12.
Zurück zum Zitat EVAR trial participants (2005) Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. Lancet 365(9478):2187–2192 EVAR trial participants (2005) Endovascular aneurysm repair and outcome in patients unfit for open repair of abdominal aortic aneurysm (EVAR trial 2): randomised controlled trial. Lancet 365(9478):2187–2192
13.
Zurück zum Zitat Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG (2004) Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 364(9437):843–848PubMedCrossRef Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG (2004) Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 364(9437):843–848PubMedCrossRef
14.
Zurück zum Zitat Higashiura W, Sakaguchi S, Tabayashi N, Taniguchi S, Kichikawa K (2008) Impact of 3-dimensional-computed tomography workstation for precise planning of endovascular aneurysm repair. Circ J 72(12):2028–2034PubMedCrossRef Higashiura W, Sakaguchi S, Tabayashi N, Taniguchi S, Kichikawa K (2008) Impact of 3-dimensional-computed tomography workstation for precise planning of endovascular aneurysm repair. Circ J 72(12):2028–2034PubMedCrossRef
15.
Zurück zum Zitat Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK, Bernhard VM, Matsumura JS, May J, Veith FJ, Fillinger MF, Rutherford RB, Kent KC (2002) Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg 35(5):1048–1060PubMedCrossRef Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK, Bernhard VM, Matsumura JS, May J, Veith FJ, Fillinger MF, Rutherford RB, Kent KC (2002) Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg 35(5):1048–1060PubMedCrossRef
16.
Zurück zum Zitat Chaikof EL, Fillinger MF, Matsumura JS, Rutherford RB, White GH, Blankensteijn JD, Bernhard VM, Harris PL, Kent KC, May J, Veith FJ, Zarins CK (2002) Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg 35(5):1061–1066PubMedCrossRef Chaikof EL, Fillinger MF, Matsumura JS, Rutherford RB, White GH, Blankensteijn JD, Bernhard VM, Harris PL, Kent KC, May J, Veith FJ, Zarins CK (2002) Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg 35(5):1061–1066PubMedCrossRef
17.
Zurück zum Zitat Rodd CD, Desigan S, Cheshire NJ, Jenkins MP, Hamady M (2011) The suitability of thoraco-abdominal aortic aneurysms for branched or fenestrated stent grafts—and the development of a new scoring method to aid case assessment. Eur J Vasc Endovasc Surg 41(2):175–185PubMedCrossRef Rodd CD, Desigan S, Cheshire NJ, Jenkins MP, Hamady M (2011) The suitability of thoraco-abdominal aortic aneurysms for branched or fenestrated stent grafts—and the development of a new scoring method to aid case assessment. Eur J Vasc Endovasc Surg 41(2):175–185PubMedCrossRef
18.
Zurück zum Zitat Timaran CH, Rosero EB, Smith ST, Modrall JG, Valentine RJ, Clagett GP (2008) Influence of age, aneurysm size, and patient fitness on suitability for endovascular aortic aneurysm repair. Ann Vasc Surg 22(6):730–735PubMedCrossRef Timaran CH, Rosero EB, Smith ST, Modrall JG, Valentine RJ, Clagett GP (2008) Influence of age, aneurysm size, and patient fitness on suitability for endovascular aortic aneurysm repair. Ann Vasc Surg 22(6):730–735PubMedCrossRef
19.
Zurück zum Zitat Umeda Y, Mori Y, Takagi H, Iwata H, Matsuno Y, Hirose H (2003) Surgical outcome of abdominal aortic aneurysm repair in patients undergoing chronic hemodialysis. Heart Vessels 18:7–11PubMedCrossRef Umeda Y, Mori Y, Takagi H, Iwata H, Matsuno Y, Hirose H (2003) Surgical outcome of abdominal aortic aneurysm repair in patients undergoing chronic hemodialysis. Heart Vessels 18:7–11PubMedCrossRef
20.
Zurück zum Zitat Cheng SW, Ting AC, Ho P, Poon JT (2004) Aortic aneurysm morphology in Asians: features affecting stent-graft application and design. J Endovasc Ther 11(6):605–612PubMedCrossRef Cheng SW, Ting AC, Ho P, Poon JT (2004) Aortic aneurysm morphology in Asians: features affecting stent-graft application and design. J Endovasc Ther 11(6):605–612PubMedCrossRef
21.
Zurück zum Zitat Bae T, Lee T, Jung IM, Ha J, Chung JK, Kim SJ (2008) Limited feasibility in endovascular aneurysm repair using currently available graft in Korea. J Korean Med Sci 23(4):651–656PubMedCrossRef Bae T, Lee T, Jung IM, Ha J, Chung JK, Kim SJ (2008) Limited feasibility in endovascular aneurysm repair using currently available graft in Korea. J Korean Med Sci 23(4):651–656PubMedCrossRef
22.
Zurück zum Zitat Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ (2010) Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 362(20):1863–1871PubMedCrossRef Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D, Sculpher MJ (2010) Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 362(20):1863–1871PubMedCrossRef
Metadaten
Titel
Candidates and major determinants for endovascular repair of abdominal aortic aneurysms in Korean patients
verfasst von
Joo Myung Lee
Cheong Lim
Tae-Jin Youn
Eun Ju Chun
Sang-Il Choi
Young-Seok Cho
Goo-Yeong Cho
In-Ho Chae
Kay-Hyun Park
Dong-Ju Choi
Publikationsdatum
01.03.2013
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 2/2013
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-011-0221-6

Weitere Artikel der Ausgabe 2/2013

Heart and Vessels 2/2013 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.