Faculty Collaboration Database

Intermediate follow-up after endovascular aneurysm repair: can we forgo CT scanning in certain patients? Ann Vasc Surg 2007 Nov;21(6):663-70

Date

11/06/2007

Pubmed ID

17980790

DOI

10.1016/j.avsg.2007.07.015

Scopus ID

2-s2.0-35548929023 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

Current recommendations for follow-up after endovascular repair of abdominal aortic aneurysms (EVAR) include yearly computed tomographic (CT) scans after the first year. We hypothesize that this is unnecessary for patients who have aneurysm sacs that are stable or shrinking at 1 year and no evidence of endoleak. To explore this hypothesis, we reviewed the records of all patients undergoing EVAR at our institution who were implanted with grafts that are currently commercially available and had a minimum of 18 months' follow-up. Of 415 patients who underwent EVAR over an 8-year period, 93 met the entry criteria. At a mean follow-up of approximately 3 years, secondary interventions were required in 13%, 39%, and 25% of patients undergoing EVAR with Zenith, AneuRx, and Excluder devices, respectively, and secondary interventions after the first year were required in 3%, 22%, and 8% of such grafts, respectively. Seventy-one patients (76%) had aneurysm sacs that were stable or shrinking at 1 year and no endoleak. Only two of these patients subsequently required reintervention. Both patients had AneuRx grafts, and both problems could have easily been identified without CT scanning. Our data support the hypothesis that patients who meet these criteria at 1 year are unlikely to have problems that cannot be identified by ultrasound and/or clinical evaluation alone and, thus, that CT scans are not necessary after this point, especially in patients with Zenith or reengineered Excluder devices.

Author List

Tomlinson J, McNamara J, Matloubieh J, Hart J, Singh MJ, Davies MG, Rhodes JM, Illig KA

Author

Joseph Hart MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Algorithms
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Selection
Postoperative Complications
Practice Guidelines as Topic
Predictive Value of Tests
Prosthesis Design
Reoperation
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography