Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports
<p>Abstract</p> <p>Introduction</p> <p>Endovascular abdominal aortic aneurysm repair is a life-saving intervention. Nevertheless, complications have a major impact. We review the evidence from case reports for risk factors of complications after endovascular abdominal a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2008-09-01
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| Series: | Journal of Medical Case Reports |
| Online Access: | http://www.jmedicalcasereports.com/content/2/1/317 |
| _version_ | 1811299184436838400 |
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| author | Schlösser Felix JV JMG van der Heijden Geert van der Graaf Yolanda Moll Frans L Verhagen Hence JM |
| author_facet | Schlösser Felix JV JMG van der Heijden Geert van der Graaf Yolanda Moll Frans L Verhagen Hence JM |
| author_sort | Schlösser Felix JV |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Endovascular abdominal aortic aneurysm repair is a life-saving intervention. Nevertheless, complications have a major impact. We review the evidence from case reports for risk factors of complications after endovascular abdominal aortic aneurysm repair.</p> <p>Case presentation</p> <p>We selected case reports from PubMed reporting original data on adverse events after endovascular abdominal aortic aneurysm repair. Extracted risk factors were: age, sex, aneurysm diameter, comorbidities, re-interventions, at least one follow-up visit being missed or refusal of a re-intervention by the patient. Extracted outcomes were: death, rupture and (non-)device-related complications.</p> <p>In total 113 relevant articles were selected. These reported on 173 patients. A fatal outcome was reported in 15% (<it>N </it>= 26) of which 50% came after an aneurysm rupture (<it>N </it>= 13). Non-fatal aneurysm rupture occurred in 15% (<it>N </it>= 25). Endoleaks were reported in 52% of the patients (<it>N </it>= 90). In half of the patients with a rupture no prior endoleak was discovered during follow-up. In 83% of the patients one or more re-interventions were performed (<it>N </it>= 143). Mortality was higher among women (risk ratio 2.9; 95% confidence interval 1.4 to 6.0), while the presence of comorbidities was strongly associated with both ruptures (risk ratio 1.6; 95% confidence interval 0.9 to 2.9) and mortality (risk ratio 2.1; 95% confidence interval 1.0 to 4.7). Missing one or more follow-up visits (≥1) or refusal of a re-intervention by the patient was strongly related to both ruptures (risk ratio 4.7; 95% confidence interval 3.1 to 7.0) and mortality (risk ratio 3.8; 95% confidence interval 1.7 to 8.3).</p> <p>Conclusion</p> <p>Female gender, the presence of comorbidities and at least one follow-up visit being missed or refusal of a re-intervention by the patient appear to increase the risk for mortality after endovascular abdominal aortic aneurysm repair. Larger aneurysm diameter, higher age and multimorbidity at the time of surgery appear to increase the risk for rupture and other complications after endovascular abdominal aortic aneurysm repair. These risk factors deserve further attention in future studies.</p> |
| first_indexed | 2024-04-13T06:32:24Z |
| format | Article |
| id | doaj.art-e9a398a0440946ab8ebd92fa140820d9 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T06:32:24Z |
| publishDate | 2008-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-e9a398a0440946ab8ebd92fa140820d92022-12-22T02:58:07ZengBMCJournal of Medical Case Reports1752-19472008-09-012131710.1186/1752-1947-2-317Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reportsSchlösser Felix JVJMG van der Heijden Geertvan der Graaf YolandaMoll Frans LVerhagen Hence JM<p>Abstract</p> <p>Introduction</p> <p>Endovascular abdominal aortic aneurysm repair is a life-saving intervention. Nevertheless, complications have a major impact. We review the evidence from case reports for risk factors of complications after endovascular abdominal aortic aneurysm repair.</p> <p>Case presentation</p> <p>We selected case reports from PubMed reporting original data on adverse events after endovascular abdominal aortic aneurysm repair. Extracted risk factors were: age, sex, aneurysm diameter, comorbidities, re-interventions, at least one follow-up visit being missed or refusal of a re-intervention by the patient. Extracted outcomes were: death, rupture and (non-)device-related complications.</p> <p>In total 113 relevant articles were selected. These reported on 173 patients. A fatal outcome was reported in 15% (<it>N </it>= 26) of which 50% came after an aneurysm rupture (<it>N </it>= 13). Non-fatal aneurysm rupture occurred in 15% (<it>N </it>= 25). Endoleaks were reported in 52% of the patients (<it>N </it>= 90). In half of the patients with a rupture no prior endoleak was discovered during follow-up. In 83% of the patients one or more re-interventions were performed (<it>N </it>= 143). Mortality was higher among women (risk ratio 2.9; 95% confidence interval 1.4 to 6.0), while the presence of comorbidities was strongly associated with both ruptures (risk ratio 1.6; 95% confidence interval 0.9 to 2.9) and mortality (risk ratio 2.1; 95% confidence interval 1.0 to 4.7). Missing one or more follow-up visits (≥1) or refusal of a re-intervention by the patient was strongly related to both ruptures (risk ratio 4.7; 95% confidence interval 3.1 to 7.0) and mortality (risk ratio 3.8; 95% confidence interval 1.7 to 8.3).</p> <p>Conclusion</p> <p>Female gender, the presence of comorbidities and at least one follow-up visit being missed or refusal of a re-intervention by the patient appear to increase the risk for mortality after endovascular abdominal aortic aneurysm repair. Larger aneurysm diameter, higher age and multimorbidity at the time of surgery appear to increase the risk for rupture and other complications after endovascular abdominal aortic aneurysm repair. These risk factors deserve further attention in future studies.</p>http://www.jmedicalcasereports.com/content/2/1/317 |
| spellingShingle | Schlösser Felix JV JMG van der Heijden Geert van der Graaf Yolanda Moll Frans L Verhagen Hence JM Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports Journal of Medical Case Reports |
| title | Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports |
| title_full | Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports |
| title_fullStr | Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports |
| title_full_unstemmed | Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports |
| title_short | Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports |
| title_sort | predictors of adverse events after endovascular abdominal aortic aneurysm repair a meta analysis of case reports |
| url | http://www.jmedicalcasereports.com/content/2/1/317 |
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