Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds
Objectives: Intraluminal prosthetic graft thrombus (IPT) following Endovascular Aneurysm Repair (EVAR) can have serious consequences. The aim of this study was to assess the prevalence of IPT and to identify the risk factors for its formation and progression. Methods: This was a retrospective study...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | EJVES Vascular Forum |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666688X22000259 |
| _version_ | 1797990690472329216 |
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| author | Terri-Ann Russell Sivaram Premnath Meera Mogan Grace Langford Bronte Paice James Kirk Timothy Rowlands Ganesh Kuhan |
| author_facet | Terri-Ann Russell Sivaram Premnath Meera Mogan Grace Langford Bronte Paice James Kirk Timothy Rowlands Ganesh Kuhan |
| author_sort | Terri-Ann Russell |
| collection | DOAJ |
| description | Objectives: Intraluminal prosthetic graft thrombus (IPT) following Endovascular Aneurysm Repair (EVAR) can have serious consequences. The aim of this study was to assess the prevalence of IPT and to identify the risk factors for its formation and progression. Methods: This was a retrospective study of 258 patients who had EVAR between 2015 and 2018. Demographic data, comorbidities, operative data, antithrombotic therapy, CT anatomical data, IPT characteristics (site, regression, and progression), and re-interventions were collected. Univariable analysis followed by multivariable logistic regression and Cox regression were used for data analysis. Results: The mean age of patients was 76 years (range 55–95) and 27 (10.5 %) were females. IPT was present in 26 patients (10.1%) with a median time to occurrence of six (range 1– - 24) months. Of the group that developed IPT, six (23.1 %) developed symptoms and two (7.7%) had re-interventions. Multivariable logistic regression analysis revealed peripheral arterial disease to be associated with the formation of IPT (OR 7.4, 95% CI 1.6–35.3, p = 0.02) and escalation of antithrombotic therapy was associated with regression or prevention of progression of IPT (OR 0.1, 95% CI 0.0–0.6, p = 0.01). Conclusion: PAD is associated with the formation of IPT after EVAR and warrants consideration of escalation of antithrombotic therapy to prevent further progression and complications. |
| first_indexed | 2024-04-11T08:39:26Z |
| format | Article |
| id | doaj.art-054e93bb2a49440b8573e612a60d0863 |
| institution | Directory Open Access Journal |
| issn | 2666-688X |
| language | English |
| last_indexed | 2024-04-11T08:39:26Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJVES Vascular Forum |
| spelling | doaj.art-054e93bb2a49440b8573e612a60d08632022-12-22T04:34:14ZengElsevierEJVES Vascular Forum2666-688X2022-01-015615Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper addsTerri-Ann Russell0Sivaram Premnath1Meera Mogan2Grace Langford3Bronte Paice4James Kirk5Timothy Rowlands6Ganesh Kuhan7Department of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UK; Corresponding author. Department of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UK.Department of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKDepartment of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKDepartment of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKDepartment of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKDepartment of Radiology, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKDepartment of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKDepartment of Vascular Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby, DE22 3NE, UKObjectives: Intraluminal prosthetic graft thrombus (IPT) following Endovascular Aneurysm Repair (EVAR) can have serious consequences. The aim of this study was to assess the prevalence of IPT and to identify the risk factors for its formation and progression. Methods: This was a retrospective study of 258 patients who had EVAR between 2015 and 2018. Demographic data, comorbidities, operative data, antithrombotic therapy, CT anatomical data, IPT characteristics (site, regression, and progression), and re-interventions were collected. Univariable analysis followed by multivariable logistic regression and Cox regression were used for data analysis. Results: The mean age of patients was 76 years (range 55–95) and 27 (10.5 %) were females. IPT was present in 26 patients (10.1%) with a median time to occurrence of six (range 1– - 24) months. Of the group that developed IPT, six (23.1 %) developed symptoms and two (7.7%) had re-interventions. Multivariable logistic regression analysis revealed peripheral arterial disease to be associated with the formation of IPT (OR 7.4, 95% CI 1.6–35.3, p = 0.02) and escalation of antithrombotic therapy was associated with regression or prevention of progression of IPT (OR 0.1, 95% CI 0.0–0.6, p = 0.01). Conclusion: PAD is associated with the formation of IPT after EVAR and warrants consideration of escalation of antithrombotic therapy to prevent further progression and complications.http://www.sciencedirect.com/science/article/pii/S2666688X22000259Abdominal aortic aneurysmEndovascular techniquesThrombusPeripheral arterial diseasesAnticoagulantAntiplatelet agents |
| spellingShingle | Terri-Ann Russell Sivaram Premnath Meera Mogan Grace Langford Bronte Paice James Kirk Timothy Rowlands Ganesh Kuhan Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds EJVES Vascular Forum Abdominal aortic aneurysm Endovascular techniques Thrombus Peripheral arterial diseases Anticoagulant Antiplatelet agents |
| title | Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds |
| title_full | Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds |
| title_fullStr | Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds |
| title_full_unstemmed | Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds |
| title_short | Escalation of Antithrombotic Therapy Should Be Considered in the Presence of Intraluminal Prosthetic Graft Thrombus Following Endovascular Aneurysm RepairWhat this paper adds |
| title_sort | escalation of antithrombotic therapy should be considered in the presence of intraluminal prosthetic graft thrombus following endovascular aneurysm repairwhat this paper adds |
| topic | Abdominal aortic aneurysm Endovascular techniques Thrombus Peripheral arterial diseases Anticoagulant Antiplatelet agents |
| url | http://www.sciencedirect.com/science/article/pii/S2666688X22000259 |
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