Endoluminal graft repair for abdominal aortic aneurysms in high-risk patients and octogenarians: is it better than open repair?
To analyze the short-term and midterm results of open and endoluminal repair of abdominal aortic aneurysms (AAA) in a large single-center series and specifically in octogenarians. Between January 1997 and October 2000, 470 consecutive patients underwent elective repair of AAA. Conventional open repa...
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| Veröffentlicht in: | Annals of surgery 2001-10, Vol.234 (4), p.427-437 |
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| creator | Sicard, G A Rubin, B G Sanchez, L A Keller, C A Flye, M W Picus, D Hovsepian, D Choi, E T Geraghty, P J Thompson, R W |
| description | To analyze the short-term and midterm results of open and endoluminal repair of abdominal aortic aneurysms (AAA) in a large single-center series and specifically in octogenarians.
Between January 1997 and October 2000, 470 consecutive patients underwent elective repair of AAA. Conventional open repair (COR) was performed in 210 patients and endoluminal graft (ELG) repair in 260 patients. Ninety of the patients were 80 years of age or older; of these, 38 underwent COR and 52 ELG repair.
Patient characteristics and risk factors were similar for both the entire series and the subgroup of patients 80 years or older. The overall complication rate was reduced by 70% or more in the ELG versus the COR groups. The postoperative death rate was similar for the COR and ELG groups in the entire series and lower (but not significantly) in the ELG 80 years or older subgroup versus the COR group. The 36-month rates of freedom from endoleaks, surgical conversion, and secondary intervention were 81%, 98.2%, and 88%, respectively.
The short-term and midterm results of AAA repair by COR or ELG are similar. The death rate associated with this new technique is low and comparable, whereas the complication rate associated with COR in all patients and those 80 years or older in particular is greater and more serious than ELG repair. Long-term results will establish the role of ELG repair of AAA, especially in elderly and high-risk patients. |
| doi_str_mv | 10.1097/00000658-200110000-00002 |
| format | Article |
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Between January 1997 and October 2000, 470 consecutive patients underwent elective repair of AAA. Conventional open repair (COR) was performed in 210 patients and endoluminal graft (ELG) repair in 260 patients. Ninety of the patients were 80 years of age or older; of these, 38 underwent COR and 52 ELG repair.
Patient characteristics and risk factors were similar for both the entire series and the subgroup of patients 80 years or older. The overall complication rate was reduced by 70% or more in the ELG versus the COR groups. The postoperative death rate was similar for the COR and ELG groups in the entire series and lower (but not significantly) in the ELG 80 years or older subgroup versus the COR group. The 36-month rates of freedom from endoleaks, surgical conversion, and secondary intervention were 81%, 98.2%, and 88%, respectively.
The short-term and midterm results of AAA repair by COR or ELG are similar. The death rate associated with this new technique is low and comparable, whereas the complication rate associated with COR in all patients and those 80 years or older in particular is greater and more serious than ELG repair. Long-term results will establish the role of ELG repair of AAA, especially in elderly and high-risk patients.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/00000658-200110000-00002</identifier><identifier>PMID: 11573036</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; Angiography ; Aortic Aneurysm, Abdominal - diagnostic imaging ; Aortic Aneurysm, Abdominal - mortality ; Aortic Aneurysm, Abdominal - surgery ; Blood Vessel Prosthesis Implantation - methods ; Chi-Square Distribution ; Elective Surgical Procedures ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications - surgery ; Probability ; Retrospective Studies ; Risk Assessment ; Scientific Papers of the American Surgical Association ; Sensitivity and Specificity ; Statistics, Nonparametric ; Survival Analysis ; Treatment Outcome ; Vascular Surgical Procedures - methods</subject><ispartof>Annals of surgery, 2001-10, Vol.234 (4), p.427-437</ispartof><rights>2001 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c311t-1e1aaafd7edeaba28a91d0e011c17438bebc40722b03fd6f48f29c4aca6129733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422066/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422066/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11573036$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sicard, G A</creatorcontrib><creatorcontrib>Rubin, B G</creatorcontrib><creatorcontrib>Sanchez, L A</creatorcontrib><creatorcontrib>Keller, C A</creatorcontrib><creatorcontrib>Flye, M W</creatorcontrib><creatorcontrib>Picus, D</creatorcontrib><creatorcontrib>Hovsepian, D</creatorcontrib><creatorcontrib>Choi, E T</creatorcontrib><creatorcontrib>Geraghty, P J</creatorcontrib><creatorcontrib>Thompson, R W</creatorcontrib><title>Endoluminal graft repair for abdominal aortic aneurysms in high-risk patients and octogenarians: is it better than open repair?</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>To analyze the short-term and midterm results of open and endoluminal repair of abdominal aortic aneurysms (AAA) in a large single-center series and specifically in octogenarians.
Between January 1997 and October 2000, 470 consecutive patients underwent elective repair of AAA. Conventional open repair (COR) was performed in 210 patients and endoluminal graft (ELG) repair in 260 patients. Ninety of the patients were 80 years of age or older; of these, 38 underwent COR and 52 ELG repair.
Patient characteristics and risk factors were similar for both the entire series and the subgroup of patients 80 years or older. The overall complication rate was reduced by 70% or more in the ELG versus the COR groups. The postoperative death rate was similar for the COR and ELG groups in the entire series and lower (but not significantly) in the ELG 80 years or older subgroup versus the COR group. The 36-month rates of freedom from endoleaks, surgical conversion, and secondary intervention were 81%, 98.2%, and 88%, respectively.
The short-term and midterm results of AAA repair by COR or ELG are similar. The death rate associated with this new technique is low and comparable, whereas the complication rate associated with COR in all patients and those 80 years or older in particular is greater and more serious than ELG repair. Long-term results will establish the role of ELG repair of AAA, especially in elderly and high-risk patients.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - mortality</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Blood Vessel Prosthesis Implantation - methods</subject><subject>Chi-Square Distribution</subject><subject>Elective Surgical Procedures</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - surgery</subject><subject>Probability</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Scientific Papers of the American Surgical Association</subject><subject>Sensitivity and Specificity</subject><subject>Statistics, Nonparametric</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Vascular Surgical Procedures - methods</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1v1DAQtRAVXQp_AfnELeCxvfngAEJVW5Aq9QJna-JMdg2JHWynUk_8dbzsUsAHW5735s3HY4yDeAOia96Kw6m3bSWFADh8qsMln7ANbGVbAWjxlG1KSFW6U_KcPU_pW-HqVjTP2DnAtlFC1Rv288oPYVpn53Hiu4hj5pEWdJGPIXLsh3CEMMTsLEdPa3xIc-LO873b7avo0ne-YHbkcyr4wIPNYUceo0Of3nFXuJn3lDNFnvfoeVjIn6p8eMHORpwSvTy9F-zr9dWXy0_V7d3N58uPt5VVALkCAkQch4YGwh5lix0MgsrwFhqt2p56q0UjZS_UONSjbkfZWY0Wa5Bdo9QFe3_UXdZ-psGWbiNOZoluxvhgAjrzP-Ld3uzCvQEtpajrIvD6JBDDj5VSNrNLlqaprCSsyTQg5VZLKMT2SLQxpBRpfCwCwhzcM3_cM4_u_Q7Jkvrq3yb_Jp7sUr8A5SGZRw</recordid><startdate>20011001</startdate><enddate>20011001</enddate><creator>Sicard, G A</creator><creator>Rubin, B G</creator><creator>Sanchez, L A</creator><creator>Keller, C A</creator><creator>Flye, M W</creator><creator>Picus, D</creator><creator>Hovsepian, D</creator><creator>Choi, E T</creator><creator>Geraghty, P J</creator><creator>Thompson, R W</creator><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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20011001</creationdate><title>Endoluminal graft repair for abdominal aortic aneurysms in high-risk patients and octogenarians: is it better than open repair?</title><author>Sicard, G A ; Rubin, B G ; Sanchez, L A ; Keller, C A ; Flye, M W ; Picus, D ; Hovsepian, D ; Choi, E T ; Geraghty, P J ; Thompson, R W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-1e1aaafd7edeaba28a91d0e011c17438bebc40722b03fd6f48f29c4aca6129733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - mortality</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Blood Vessel Prosthesis Implantation - methods</topic><topic>Chi-Square Distribution</topic><topic>Elective Surgical Procedures</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - surgery</topic><topic>Probability</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Scientific Papers of the American Surgical Association</topic><topic>Sensitivity and Specificity</topic><topic>Statistics, Nonparametric</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Vascular Surgical Procedures - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sicard, G A</creatorcontrib><creatorcontrib>Rubin, B G</creatorcontrib><creatorcontrib>Sanchez, L A</creatorcontrib><creatorcontrib>Keller, C A</creatorcontrib><creatorcontrib>Flye, M W</creatorcontrib><creatorcontrib>Picus, D</creatorcontrib><creatorcontrib>Hovsepian, D</creatorcontrib><creatorcontrib>Choi, E T</creatorcontrib><creatorcontrib>Geraghty, P J</creatorcontrib><creatorcontrib>Thompson, R W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sicard, G A</au><au>Rubin, B G</au><au>Sanchez, L A</au><au>Keller, C A</au><au>Flye, M W</au><au>Picus, D</au><au>Hovsepian, D</au><au>Choi, E T</au><au>Geraghty, P J</au><au>Thompson, R W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoluminal graft repair for abdominal aortic aneurysms in high-risk patients and octogenarians: is it better than open repair?</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2001-10-01</date><risdate>2001</risdate><volume>234</volume><issue>4</issue><spage>427</spage><epage>437</epage><pages>427-437</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><abstract>To analyze the short-term and midterm results of open and endoluminal repair of abdominal aortic aneurysms (AAA) in a large single-center series and specifically in octogenarians.
Between January 1997 and October 2000, 470 consecutive patients underwent elective repair of AAA. Conventional open repair (COR) was performed in 210 patients and endoluminal graft (ELG) repair in 260 patients. Ninety of the patients were 80 years of age or older; of these, 38 underwent COR and 52 ELG repair.
Patient characteristics and risk factors were similar for both the entire series and the subgroup of patients 80 years or older. The overall complication rate was reduced by 70% or more in the ELG versus the COR groups. The postoperative death rate was similar for the COR and ELG groups in the entire series and lower (but not significantly) in the ELG 80 years or older subgroup versus the COR group. The 36-month rates of freedom from endoleaks, surgical conversion, and secondary intervention were 81%, 98.2%, and 88%, respectively.
The short-term and midterm results of AAA repair by COR or ELG are similar. The death rate associated with this new technique is low and comparable, whereas the complication rate associated with COR in all patients and those 80 years or older in particular is greater and more serious than ELG repair. Long-term results will establish the role of ELG repair of AAA, especially in elderly and high-risk patients.</abstract><cop>United States</cop><pmid>11573036</pmid><doi>10.1097/00000658-200110000-00002</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete; PubMed (Medline); Free E-Journal (出版社公開部分のみ） |
| subjects | Adult Age Factors Aged Aged, 80 and over Angiography Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - surgery Blood Vessel Prosthesis Implantation - methods Chi-Square Distribution Elective Surgical Procedures Endoscopy Female Humans Male Middle Aged Postoperative Complications - surgery Probability Retrospective Studies Risk Assessment Scientific Papers of the American Surgical Association Sensitivity and Specificity Statistics, Nonparametric Survival Analysis Treatment Outcome Vascular Surgical Procedures - methods |
| title | Endoluminal graft repair for abdominal aortic aneurysms in high-risk patients and octogenarians: is it better than open repair? |
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