News | April 01, 2009

Endovascular Repair Safer, More Successful for Some Ruptured Aneurysms

April 1, 2009 - Endovascular aortic repair (EVAR) used to repair ruptured abdominal aortic aneurysms (RAAAs) had a significant mortality benefit, according to five-year study published in the April issue of the Journal of Vascular Surgery.

The study, conducted by researchers from the University of Massachusetts Memorial Medical Center’s division of vascular and endovascular surgery in Worcester, examined the national frequency, predictors, outcomes, and the effect of institutional volume metrics in cases where endovascular aortic repair (EVAR) was used to repair ruptured abdominal aortic aneurysms (RAAAs) between 2001 and 2006.

Over the years EVAR has gained wide acceptance for the elective treatment of abdominal aortic aneurysms (AAA). This success has led to increased interest in similar treatment of RAAAs, because most patients who suffer a RAAA do not survive long enough to obtain medical care. The mortality rate for patients who do survive and undergo traditional open surgical repair continues to exceed 40 percent.

In this study, an estimated 27,750 hospital discharges for RAAA occurred, of which 11.5 percent were treated with EVAR. Data was secured through the Nationwide Inpatient Sample to evaluate operative outcomes.

"While the incidence of RAAA remained fairly constant, EVAR was used to treat RAAA in an increasing proportion of patients - from 5.9 percent in 2001 to 18.9 percent in 2006," said Andres Schanzer, M.D., assistant professor of surgery in the division. Researchers found that EVAR was independently associated with a lower postoperative mortality risk than was open repair (31.7 percent versus 40.7 percent).

"Elective surgery was the strongest predictor of the use of EVAR for RAAA repairs," added Dr. Schanzer. "The use of EVAR for RAAA also increased in patients more than 80 years of age. Additionally, EVAR patients had a shorter length of stay (11.1 vs. 13.8 days for open repair); more discharges to home (65.1 percent vs. 53.9 percent); and lower hospital charges ($108,672 vs. $114,784)."

Procedure volume was determined for each institution where hospitals were categorized as low, medium or high volume. Researchers noted that even after adjustment for hospital surgical volume characteristics, teaching hospitals continued to show lower mortality risks following RAAA repair than non-teaching hospitals.

Dr. Schanzer said that the study results support regionalization of RAAA repair to high volume centers whenever possible and a wider adoption of endovascular repair nationwide. "Through such a system appropriate patients could be rapidly transferred to institutions with EVAR capabilities, thus potentially decreasing the in-hospital mortality rate for this critically ill patient population," he added.

For more information: www.jvascsurg.org

Related Content

Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Siemens Healthineers Announces First U.S. Install of Artis Pheno Angiography System
News | Angiography | July 05, 2017
July 5, 2017 — Michigan Medicine recently became the first healthcare institution in the United States to install the
RaySafe Introduces Pro-Slit Camera for Accurate Focal Spot Measurement
Technology | Digital Radiography (DR) | June 27, 2017
Unfors RaySafe recently introduced the RaySafe Pro-Slit Phantom and the RaySafe Pro-Stand.
New Hampshire Hospital Expands Vascular Care with Toshiba Medical's Infinix-i Sky +
News | Angiography | April 27, 2017
Wentworth-Douglass Hospital in Dover, N.H., installed Toshiba Medical’s Infinix-i Sky + angiography system in its...
Louisiana Medical Center Installs First U.S. Toshiba Medical Infinix-i Sky +
News | Angiography | April 18, 2017
Patients at Terrebonne General Medical Center (TGMC) in Houma, La., now have access to safe, high-quality...
Siemens Healthineers, ACC 2017, syngo CTO Guidance, Compressed Sensing Cardiac Cine
News | Cardiac Imaging | March 16, 2017
During the 66th Annual Scientific Session & Expo of the American College of Cardiology (ACC), March 17-19 in...
Siemens Healthineers, Artis pheno angiography system, FDA approval, ACC 2017, RSNA 2017
Technology | Angiography | March 15, 2017
The U.S. Food and Drug Administration (FDA) has cleared the Artis pheno robotic C-arm angiography system from Siemens...
Technical University of Munich, Munich Compact Light Source, MuCLS, angiography, contrast agents

(a) Photograph of the sample in waterbath. (b) Empty image of full MuCLS beam. (c) Quasi-mono-energetic angiography image of a porcine heart acquired at the MuCLS, with iodine-based contrast agent injected into the left coronary artery. Visible are the left anterior descending artery (LAD) and the left circumflex artery (LCX). Image courtesy of the authors.

News | Angiography | March 10, 2017
The most prevalent method for obtaining images of clogged coronary vessels is coronary angiography. For some patients,...
ON Semiconductor, KAF-09001 image sensor, video imaging, digital radiography, angiography, radiographic fluoroscopy, R/F systems
Technology | Radiographic Fluoroscopy (RF) | March 06, 2017
ON Semiconductor announced the release of a new CCD image sensor that enables video imaging under reduced X-ray dosage...
Philips, Azurion platform, angiography, interventional lab, global launch
Technology | Hybrid OR | March 03, 2017
Philips recently announced the global launch of Azurion, its next-generation image-guided therapy platform.
Overlay Init