• Vascular Annual Meeting
• Call for Abstracts
• General Information
• Exhibitor Information
• Alumni Association Information
• 2009 Meeting Information
• Future Meeting Dates
• Contact Us

Home > Vascular Annual Meeting > PVSS9. The Effect of Secondary Procedures and...

PVSS9. The Effect of Secondary Procedures and Alternate Operative Exposures on Early Outcomes of Endovascular Aneurysm Repair

David J. Minion, MD; Daniel L. Davenport, PhD; Eleftherios S. Xenos, MD; Ehab E. Sorial, MD; Eric D. Endean, MD
University of Kentucky Med. Ctr., Lexington, KY

OBJECTIVES: Technical success during endovascular aneurysm repair (EVAR) often requires secondary procedures such as extension cuffs, stents, or coil embolization. Further, arterial access can be achieved from a femoral exposure, iliac exposure, or percutaneously. The purpose of this study was to determine the effect of these variables on early outcomes.

METHODS: Patients in the National Surgical Quality Improvement Program (NSQIP) participant use file who underwent elective EVAR for AAA using a modular, bifurcated configuration from 2005-2007 were stratified by the need for adjuvant interventions and type of operative exposure using CPT codes. 30-day outcomes were compared using T-test and analyses of variance (ANOVA). Composite morbidity included patients experiencing one or more of 21 complications defined by NSQIP protocol.

RESULTS: Our query yielded 2,738 patients. Overall mortality was 1.0% and morbidity 9.6%. All secondary procedures were associated with increased intraoperative transfusion. Coil embolization was associated with increased morbidity (Table 1). The need for iliac exposure (either unplanned or elective) was relatively rare (n=33, 1.2% of cases) but a significant predictor of adverse outcomes (Table 2). When no exposure was coded (percutaneous?), outcomes were similar to femoral exposure.

CONCLUSIONS: Coil embolization during EVAR increases perioperative morbidity. The need for iliac exposure greatly increases both peri-operative morbidity and mortality. The data suggests that there is little benefit to percutaneous access.

AUTHOR DISCLOSURES: D.J. Minion, W.L.Gore; D.L. Davenport, None; E.S. Xenos, None: E.E. Sorial, None; E.D. Endean, None.

Tables 1-2.