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Longitudinal Outcomes After Endovascular Repair of Abdominal Aortic Aneurysms

Robert Wood Johnson Medical School, Division of Vascular Surgery, New Brunswick, New Jersey, vogelto{at}undnj.edu

R.G. Symons, MPH

Surgical Outcomes Research Center, Department of Surgery, University of Washington, Seattle, Washington

D.R. Flum, MD, MPH

Surgical Outcomes Research Center, Department of Surgery, University of Washington, Seattle, Washington

Objective: Endovascular abdominal aneurysm repair (EVAR) is increasingly used, but there is insufficient evaluation of long-term outcomes. Method: Retrospective cohort study using the linked Washington State hospital discharge database. Result: 3,350 patients underwent elective repair of AAA (1181 EVAR) between 2000 and 2005. EVAR patients were older and had higher comorbidity scores. The 30-day readmission rate after EVAR was 11.6%. The 30-day readmissions included cardiac complications (18.5%) and device complications (10.4%). 46% of the 30-day readmissions after EVAR underwent procedures: abdominal/ iliac angiography (7.4%), angioplasty (8.9%), and device revision (8.2%). Mean time to late interventions was 611 days. Conclusion: Readmission, reintervention, and complication rates after EVAR occur more commonly than previously described. Cardiac complications were the most common readmission. Almost half of the 30-day readmissions required a secondary intervention. Long-term complications after EVAR occurred before two years. Population-based assessment may be more reflective of "real world" complication rates after EVAR.

Key Words: abdominal aortic aneurysm • endovascular repair • outcomes • complications

This version was published on October 1, 2008

Vascular and Endovascular Surgery, Vol. 42, No. 5, 412-419 (2008)
DOI: 10.1177/1538574408316143


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