International validation of a risk score for complications and reinterventions after endovascular aneurysm repair
Background Lifelong surveillance is considered mandatory after endovascular repair (EVAR) of abdominal aortic aneurysms to detect endograft complications and prevent aneurysm rupture. Current protocols are not cost‐effective or clinically effective. The international validity of the St George's...
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Published in | British journal of surgery Vol. 102; no. 5; pp. 509 - 515 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Chichester, UK
John Wiley & Sons, Ltd
01.04.2015
Oxford University Press |
Subjects | |
Online Access | Get full text |
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Summary: | Background
Lifelong surveillance is considered mandatory after endovascular repair (EVAR) of abdominal aortic aneurysms to detect endograft complications and prevent aneurysm rupture. Current protocols are not cost‐effective or clinically effective. The international validity of the St George's Vascular Institute (SGVI) score for EVAR complications was examined.
Methods
The ENGAGE registry recruited patients undergoing EVAR at 79 centres in 30 countries. Reinterventions and endograft complications were recorded for up to 3 years after surgery. Preoperative aneurysm morphology was extracted from the registry database, and used to predict whether patients would be at low or high risk of complications after EVAR based on the SGVI score. Kaplan–Meier analysis was used to compare the incidence of endograft complications and reinterventions in patients predicted to be at low risk compared with those predicted to be at high risk.
Results
Some 1207 patients underwent EVAR, with follow‐up of up to 3 years. The SGVI score accurately discriminated freedom from reinterventions (90·5 versus 79·3 per cent in low‐ versus high‐risk patients; P < 0·001), freedom from endograft complications (77·9 versus 69·6 per cent in low‐ versus high‐risk patients; P = 0·012), and freedom from a composite outcome measure of reinterventions or endograft complications (75·0 versus 66·1 per cent in low‐ versus high‐risk patients; P = 0·006) during mid‐term follow‐up.
Conclusion
This study has provided international validation of a morphological risk score that predicts mid‐term reinterventions and endograft complications. The results may enable risk‐stratified surveillance after EVAR.
Score validated |
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Bibliography: | ark:/67375/WNG-JRLZ7PT1-2 ArticleID:BJS9758 istex:71632725043735FE070C7194A319E433BF144276 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Undefined-2 |
ISSN: | 0007-1323 1365-2168 |
DOI: | 10.1002/bjs.9758 |