Risk-Adjusted Outcome Analysis of Endovascular Abdominal Aortic Aneurysm Repair in a Large Population: How Do Stent-Grafts Compare?
Purpose: To compare differences in the applicability and incidence of postoperative adverse events among stent-grafts used for repair of infrarenal aortic aneurysms. Methods: An analysis of 6787 patients from the EUROSTAR Registry database was conducted to compare aneurysm morphological features, pa...
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creator | van Marrewijk, Corine J. Leurs, Lina J. Vallabhaneni, Srinivasa R. Harris, Peter L. Buth, Jacob Laheij, Robert J.F. |
description | Purpose:
To compare differences in the applicability and incidence of postoperative adverse events among stent-grafts used for repair of infrarenal aortic aneurysms.
Methods:
An analysis of 6787 patients from the EUROSTAR Registry database was conducted to compare aneurysm morphological features, patient characteristics, and postoperative events for the AneuRx, EVT/Ancure, Excluder, Stentor, Talent, and Zenith devices versus the Vanguard device (control) and each other. Annual incidence rates of complications were determined, and risks were compared using the Cox proportional hazards analysis.
Results:
The annual incidence rates were: device-related endoleak (types I and III) 6% (range 4%-10%), type II endoleak 5% (range 0.3%-11%), migration 3% (range 0.5%-5%), kinking 2% (range 1%-5%), occlusion 3% (range 1%-5%), rupture 0.5% (range 0%-1%), and all-cause mortality 7% (range 5%-8%). After adjustment for factors influencing outcome, AneuRx, Excluder, Talent, and Zenith devices were associated with a lower risk of migration, kinking, occlusion, and secondary intervention compared to the Vanguard device. Significant increased risk for conversion (EVT/Ancure) and reduced risk of aneurysm rupture (AneuRx and Zenith) and all-cause mortality (Excluder) were found compared to the Vanguard device.
Conclusions:
Significant differences exist between stent-grafts of different labels in terms of applicability and complications during intermediate to long-term follow-up. Since each stent-graft has its drawbacks, no single label can be identified as the best. It is reassuring that developments in stent-grafts indeed result in better performance than the early stent-grafts. However, a single device incorporating all the perceived improvements should still be pursued. |
doi_str_mv | 10.1583/05-1530R.1 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68082452</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_05-1530R.1</sage_id><sourcerecordid>68082452</sourcerecordid><originalsourceid>FETCH-LOGICAL-c409t-87bd5fca701af5b0249a100663b0e9d3d7083438caa5062b4b816a04919ca3cf3</originalsourceid><addsrcrecordid>eNpt0U-L1DAYBvAgLu66evEDSPCgIHR90zRt6kXKuH-EgZVRz-Ftmi4Z26YmqTJnv7iZnYGFxVMS8ssTkoeQVwwumJD8A4iMCQ6bC_aEnDFR7JcCnu7neZmVkMtT8jyELUDOcsaekVNWQiF5xc_I340NP7Om2y4hmo7eLlG70dBmwmEXbKCup5dT535j0MuAnjZt50abdmnjfLQ6SbP4XRjpxsxoPbUTRbpGf2foVzenM9G66SO9cX_oZ0e_RTPF7NpjHwNduXFGbz69ICc9DsG8PI7n5MfV5ffVTba-vf6yataZLqCOmazaTvQaK2DYixbyokYGUJa8BVN3vKtA8oJLjSigzNuilaxEKGpWa-S65-fk7SF39u7XYkJUow3aDANOxi1BlRJkXog8wTeP4NYtPj06qPR_UEMleELvD0h7F4I3vZq9HdHvFAO170WBUPe9KJbw62Pi0o6me6DHIhJ4dwAB78zDdf-J-gerX5N7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211090753</pqid></control><display><type>article</type><title>Risk-Adjusted Outcome Analysis of Endovascular Abdominal Aortic Aneurysm Repair in a Large Population: How Do Stent-Grafts Compare?</title><source>SAGE Complete A-Z List</source><source>MEDLINE</source><creator>van Marrewijk, Corine J. ; Leurs, Lina J. ; Vallabhaneni, Srinivasa R. ; Harris, Peter L. ; Buth, Jacob ; Laheij, Robert J.F.</creator><creatorcontrib>van Marrewijk, Corine J. ; Leurs, Lina J. ; Vallabhaneni, Srinivasa R. ; Harris, Peter L. ; Buth, Jacob ; Laheij, Robert J.F. ; EUROSTAR collaborators</creatorcontrib><description>Purpose:
To compare differences in the applicability and incidence of postoperative adverse events among stent-grafts used for repair of infrarenal aortic aneurysms.
Methods:
An analysis of 6787 patients from the EUROSTAR Registry database was conducted to compare aneurysm morphological features, patient characteristics, and postoperative events for the AneuRx, EVT/Ancure, Excluder, Stentor, Talent, and Zenith devices versus the Vanguard device (control) and each other. Annual incidence rates of complications were determined, and risks were compared using the Cox proportional hazards analysis.
Results:
The annual incidence rates were: device-related endoleak (types I and III) 6% (range 4%-10%), type II endoleak 5% (range 0.3%-11%), migration 3% (range 0.5%-5%), kinking 2% (range 1%-5%), occlusion 3% (range 1%-5%), rupture 0.5% (range 0%-1%), and all-cause mortality 7% (range 5%-8%). After adjustment for factors influencing outcome, AneuRx, Excluder, Talent, and Zenith devices were associated with a lower risk of migration, kinking, occlusion, and secondary intervention compared to the Vanguard device. Significant increased risk for conversion (EVT/Ancure) and reduced risk of aneurysm rupture (AneuRx and Zenith) and all-cause mortality (Excluder) were found compared to the Vanguard device.
Conclusions:
Significant differences exist between stent-grafts of different labels in terms of applicability and complications during intermediate to long-term follow-up. Since each stent-graft has its drawbacks, no single label can be identified as the best. It is reassuring that developments in stent-grafts indeed result in better performance than the early stent-grafts. However, a single device incorporating all the perceived improvements should still be pursued.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/05-1530R.1</identifier><identifier>PMID: 16048373</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Aneurysm, Ruptured - diagnostic imaging ; Aneurysm, Ruptured - mortality ; Aneurysm, Ruptured - surgery ; Aortic Aneurysm, Abdominal - diagnostic imaging ; Aortic Aneurysm, Abdominal - mortality ; Aortic Aneurysm, Abdominal - surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - methods ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications - mortality ; Probability ; Prosthesis Design ; Prosthesis Failure ; Radiography ; Registries ; Risk Assessment ; Sex Distribution ; Stents ; Survival Analysis ; United Kingdom - epidemiology</subject><ispartof>Journal of endovascular therapy, 2005-08, Vol.12 (4), p.417-429</ispartof><rights>2005 SAGE Publications</rights><rights>Copyright Allen Press, Inc. Aug 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-87bd5fca701af5b0249a100663b0e9d3d7083438caa5062b4b816a04919ca3cf3</citedby><cites>FETCH-LOGICAL-c409t-87bd5fca701af5b0249a100663b0e9d3d7083438caa5062b4b816a04919ca3cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/05-1530R.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/05-1530R.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21800,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16048373$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Marrewijk, Corine J.</creatorcontrib><creatorcontrib>Leurs, Lina J.</creatorcontrib><creatorcontrib>Vallabhaneni, Srinivasa R.</creatorcontrib><creatorcontrib>Harris, Peter L.</creatorcontrib><creatorcontrib>Buth, Jacob</creatorcontrib><creatorcontrib>Laheij, Robert J.F.</creatorcontrib><creatorcontrib>EUROSTAR collaborators</creatorcontrib><title>Risk-Adjusted Outcome Analysis of Endovascular Abdominal Aortic Aneurysm Repair in a Large Population: How Do Stent-Grafts Compare?</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To compare differences in the applicability and incidence of postoperative adverse events among stent-grafts used for repair of infrarenal aortic aneurysms.
Methods:
An analysis of 6787 patients from the EUROSTAR Registry database was conducted to compare aneurysm morphological features, patient characteristics, and postoperative events for the AneuRx, EVT/Ancure, Excluder, Stentor, Talent, and Zenith devices versus the Vanguard device (control) and each other. Annual incidence rates of complications were determined, and risks were compared using the Cox proportional hazards analysis.
Results:
The annual incidence rates were: device-related endoleak (types I and III) 6% (range 4%-10%), type II endoleak 5% (range 0.3%-11%), migration 3% (range 0.5%-5%), kinking 2% (range 1%-5%), occlusion 3% (range 1%-5%), rupture 0.5% (range 0%-1%), and all-cause mortality 7% (range 5%-8%). After adjustment for factors influencing outcome, AneuRx, Excluder, Talent, and Zenith devices were associated with a lower risk of migration, kinking, occlusion, and secondary intervention compared to the Vanguard device. Significant increased risk for conversion (EVT/Ancure) and reduced risk of aneurysm rupture (AneuRx and Zenith) and all-cause mortality (Excluder) were found compared to the Vanguard device.
Conclusions:
Significant differences exist between stent-grafts of different labels in terms of applicability and complications during intermediate to long-term follow-up. Since each stent-graft has its drawbacks, no single label can be identified as the best. It is reassuring that developments in stent-grafts indeed result in better performance than the early stent-grafts. However, a single device incorporating all the perceived improvements should still be pursued.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysm, Ruptured - diagnostic imaging</subject><subject>Aneurysm, Ruptured - mortality</subject><subject>Aneurysm, Ruptured - surgery</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - mortality</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - methods</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - mortality</subject><subject>Probability</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure</subject><subject>Radiography</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Sex Distribution</subject><subject>Stents</subject><subject>Survival Analysis</subject><subject>United Kingdom - epidemiology</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpt0U-L1DAYBvAgLu66evEDSPCgIHR90zRt6kXKuH-EgZVRz-Ftmi4Z26YmqTJnv7iZnYGFxVMS8ssTkoeQVwwumJD8A4iMCQ6bC_aEnDFR7JcCnu7neZmVkMtT8jyELUDOcsaekVNWQiF5xc_I340NP7Om2y4hmo7eLlG70dBmwmEXbKCup5dT535j0MuAnjZt50abdmnjfLQ6SbP4XRjpxsxoPbUTRbpGf2foVzenM9G66SO9cX_oZ0e_RTPF7NpjHwNduXFGbz69ICc9DsG8PI7n5MfV5ffVTba-vf6yataZLqCOmazaTvQaK2DYixbyokYGUJa8BVN3vKtA8oJLjSigzNuilaxEKGpWa-S65-fk7SF39u7XYkJUow3aDANOxi1BlRJkXog8wTeP4NYtPj06qPR_UEMleELvD0h7F4I3vZq9HdHvFAO170WBUPe9KJbw62Pi0o6me6DHIhJ4dwAB78zDdf-J-gerX5N7</recordid><startdate>20050801</startdate><enddate>20050801</enddate><creator>van Marrewijk, Corine J.</creator><creator>Leurs, Lina J.</creator><creator>Vallabhaneni, Srinivasa R.</creator><creator>Harris, Peter L.</creator><creator>Buth, Jacob</creator><creator>Laheij, Robert J.F.</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20050801</creationdate><title>Risk-Adjusted Outcome Analysis of Endovascular Abdominal Aortic Aneurysm Repair in a Large Population: How Do Stent-Grafts Compare?</title><author>van Marrewijk, Corine J. ; Leurs, Lina J. ; Vallabhaneni, Srinivasa R. ; Harris, Peter L. ; Buth, Jacob ; Laheij, Robert J.F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-87bd5fca701af5b0249a100663b0e9d3d7083438caa5062b4b816a04919ca3cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysm, Ruptured - diagnostic imaging</topic><topic>Aneurysm, Ruptured - mortality</topic><topic>Aneurysm, Ruptured - surgery</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - mortality</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - methods</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - mortality</topic><topic>Probability</topic><topic>Prosthesis Design</topic><topic>Prosthesis Failure</topic><topic>Radiography</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Sex Distribution</topic><topic>Stents</topic><topic>Survival Analysis</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Marrewijk, Corine J.</creatorcontrib><creatorcontrib>Leurs, Lina J.</creatorcontrib><creatorcontrib>Vallabhaneni, Srinivasa R.</creatorcontrib><creatorcontrib>Harris, Peter L.</creatorcontrib><creatorcontrib>Buth, Jacob</creatorcontrib><creatorcontrib>Laheij, Robert J.F.</creatorcontrib><creatorcontrib>EUROSTAR collaborators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Marrewijk, Corine J.</au><au>Leurs, Lina J.</au><au>Vallabhaneni, Srinivasa R.</au><au>Harris, Peter L.</au><au>Buth, Jacob</au><au>Laheij, Robert J.F.</au><aucorp>EUROSTAR collaborators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk-Adjusted Outcome Analysis of Endovascular Abdominal Aortic Aneurysm Repair in a Large Population: How Do Stent-Grafts Compare?</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2005-08-01</date><risdate>2005</risdate><volume>12</volume><issue>4</issue><spage>417</spage><epage>429</epage><pages>417-429</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To compare differences in the applicability and incidence of postoperative adverse events among stent-grafts used for repair of infrarenal aortic aneurysms.
Methods:
An analysis of 6787 patients from the EUROSTAR Registry database was conducted to compare aneurysm morphological features, patient characteristics, and postoperative events for the AneuRx, EVT/Ancure, Excluder, Stentor, Talent, and Zenith devices versus the Vanguard device (control) and each other. Annual incidence rates of complications were determined, and risks were compared using the Cox proportional hazards analysis.
Results:
The annual incidence rates were: device-related endoleak (types I and III) 6% (range 4%-10%), type II endoleak 5% (range 0.3%-11%), migration 3% (range 0.5%-5%), kinking 2% (range 1%-5%), occlusion 3% (range 1%-5%), rupture 0.5% (range 0%-1%), and all-cause mortality 7% (range 5%-8%). After adjustment for factors influencing outcome, AneuRx, Excluder, Talent, and Zenith devices were associated with a lower risk of migration, kinking, occlusion, and secondary intervention compared to the Vanguard device. Significant increased risk for conversion (EVT/Ancure) and reduced risk of aneurysm rupture (AneuRx and Zenith) and all-cause mortality (Excluder) were found compared to the Vanguard device.
Conclusions:
Significant differences exist between stent-grafts of different labels in terms of applicability and complications during intermediate to long-term follow-up. Since each stent-graft has its drawbacks, no single label can be identified as the best. It is reassuring that developments in stent-grafts indeed result in better performance than the early stent-grafts. However, a single device incorporating all the perceived improvements should still be pursued.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>16048373</pmid><doi>10.1583/05-1530R.1</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Age Distribution Aged Aged, 80 and over Aneurysm, Ruptured - diagnostic imaging Aneurysm, Ruptured - mortality Aneurysm, Ruptured - surgery Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - surgery Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - methods Cohort Studies Female Follow-Up Studies Humans Incidence Male Middle Aged Postoperative Complications - mortality Probability Prosthesis Design Prosthesis Failure Radiography Registries Risk Assessment Sex Distribution Stents Survival Analysis United Kingdom - epidemiology |
title | Risk-Adjusted Outcome Analysis of Endovascular Abdominal Aortic Aneurysm Repair in a Large Population: How Do Stent-Grafts Compare? |
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