No Differences in Perioperative Outcome between Symptomatic and Asymptomatic AAAs after EVAR: An Analysis from the ENGAGE Registry

• Published in: European journal of vascular and endovascular surgery 2012-06, Vol.43 (6), p.667-673
• Main Authors: Stokmans, R.A, Teijink, J.A.W, Cuypers, P.W.M, Riambau, V, van Sambeek, M.R.H.M
• Format: Article
• Language: English
• Subjects: Abdominal aortic aneurysm (AAA); Abdominal Pain - etiology; Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal - complications; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Asymptomatic Diseases; Back Pain - etiology; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - mortality; Elective Surgical Procedures; Elective treatment; Endovascular aneurysm repair (EVAR); Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Endovascular Procedures - mortality; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Outcome; Prosthesis Design; Registries; Retrospective Studies; Risk Assessment; Risk Factors; Stents; Surgery; Symptomatic AAA; Time Factors; Treatment Outcome; Urgent treatment
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2012.02.034

Abstract Aim This study aimed to compare the differences in perioperative outcome after endovascular repair of symptomatic abdominal aneurysms (S-AAAs) and elective non-symptomatic AAAs (E-AAAs). Data from the ENGAGE Registry were used for the analysis. Methods Between March 2009 and December 2010, 1200 AAA patients were enrolled from 79 sites in 30 countries and treated with an Endurant Stent Graft. S-AAAs defined as AAAs accompanied by abdominal or back pain, without rupture, were present in 185 (15.4%) patients and E-AAAs in 1015 (84.6%) patients. Multivariate logistic regression was used to compare results. Results At baseline, E-AAA patients had larger aneurysms on average ( P  = 0.006) and scored higher ASA classification more often ( P  = 0.001). Further analyses were corrected for baseline differences. Operation time and technical success were comparable, and S-AAAs were admitted to the Intensive Care Unit (ICU) as often as E-AAAs (35.7% vs. 33.4%, P  = 0.479). Post-operative hospitalisation was similar (4.83 ± 5.29 in E-AAAs and 4.37 ± 3.49 in S-AAAs, P  = 0.360). No differences in the occurrence of major adverse events, including mortality, within the 30-day post-implantation were seen between S-AAA and E-AAA patients, respectively, 3.2% and 4.2% ( P  = 0.572). Conclusion With contemporary devices and technical proficiency, there is no difference in outcome between symptomatic AAA and elective non-symptomatic AAA patients if treated with endovascular techniques.