Applicability of ASA classification system in elective endovascular aneurysm repair

Aytekin, Bahadır

doi:10.9739/tjvs.2019.442

Cited by 4 publications

(3 citation statements)

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“…According to a study published in 2019, ICU and hospital stay were longer in ASA 3 and 4 patients. However, 1 year mortality and morbidity rates did not differ significantly between low and high risk ASA groups [15]. In contrast, our results showed that long-term mortality rates were higher in the high risk ASA 3 and 4 groups and in addition, the duration of ICU stay was weakly correlated with the ASA grades.…”

Section: Discussioncontrasting

confidence: 89%

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Özen

Yılmaz²,

Yiğit

et al. 2021

BMC Cardiovasc Disord

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Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors (group 1) and the long-term mortality (group 2) groups. Cox regression analysis was used to determine independent predictors of late mortality. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Survival analysis was conducted using Kaplan-Meier. Results The study included 257 patients with a mean age of 69.75 ± 7.75 (46–92), who underwent EVAR due to AAA. Average follow up period was 18.98 ± 22.84 months (0–88). Fourty-five (17.8%) mortalities occured during long-term follow-up. A past medical history of cancer resulted in a 2.5 fold increase in risk of long-term mortality (OR: 2.52, 95% CI 1.10–5.76; p = 0.029). GAS values were higher in group 2 compared to group 1 (81.02 ± 10.33 vs. 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and the GAS cut-off value was 77.5 (specificity 64%, p < 0.001). The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% and 24.8% respectively (p = 0.014). Every 10 point increase in GAS resulted in approximately a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI 1.3–2.5; p < 0.001). Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusions The findings of our study suggests that an increase in GAS score may predict long-term mortality. In addition, the mortality rates in patients above the GAS cut-off value almost doubled compared to those below. Furthermore, the presence of a past history of cancer resulted in a 2.5 fold increase in long-term mortality risk. Addition of cancer to the GAS scoring system may be considered in future studies. Further studies are necessary to consolidate these findings.

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Section: Discussioncontrasting

confidence: 89%

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Özen

Yılmaz²,

Yiğit

et al. 2021

BMC Cardiovasc Disord

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“…We evaluated all patients with ASA classi cation preoperatively, which is the most helpful in predicting perioperative risks. We found that, as the ASA score increased, mortality signi cantly increased likely in the literature [32]. Risk factors in terms of graft characteristics were determined with Roc analysis, and mortality increased with aortic coverage length larger than 25 cm.…”

Section: Discussionmentioning

confidence: 87%

Long-Term Outcomes of TEVAR for Thoracic Aortic Diseases: A Retrospective Single-Center Study

Deniz¹,

Özçınar²,

Kasimzade³

et al. 2022

Preprint

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Background: Long-term outcomes of TEVAR for different aortic pathologies are still debated for years. The procedural success and outcomes differ by comorbidities and thoracic aortic pathologies. Therefore, we present our ten-year experience, encountered rare complications, and long-term results. Methods: Between 2006 to 2018, 97 patients underwent endovascular treatment for several indications. The primary endpoints are to explore the leading mortality causes, complications, and reinterventions, evaluate the effects of comorbidities on survival, and compare several indications with survival curves. The second is to investigate rare complications and graft durability in long-term follow-ups. Results: The most indication was thoracic aortic aneurysm (n=52). Ten patients had aortic arch variations and anomalies, and the bovine arch was observed in 8 patients. Endoleaks were the main encountered complication, and 10 of 15 endoleaks were type 1 endoleak. Total reinvention was 18, and the most intervention was reTEVAR (n=5). Overall mortality was 20, and TEVAR-related death mortality was 12. Multivariant Cox regression revealed chronic renal diseases (OR=11.73; 95% CI:2.04-67.2; p=0.006), previous cardiac operation (OR:14.26; 95% CI: 1.59-127.36; p=0.01), chronic obstructive pulmonary diseases (OR:7.82; 95% CI: 1.43-42.78; p=0.001) to be an independent risk factor for 10-year-survival. There was no significant difference in the Kaplan-Maier survival curves of different aortic pathologies. Conclusion: In long-term follow-ups, comorbid factors could independently be risk factors for mortality; however, there is no significant difference in endoleaks occurrence. TEVAR is a suitable solution for severe aortic pathologies with similar outcomes. Graft thrombosis in years should be a question on graft durability.

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“…Additionally, our findings indicate a correlation between higher ASA scores and increased mortality rates. Preoperative ASA status can predict perioperative outcomes [ 33 ]. Risk factor analysis through receiver operating characteristics curves identified graft characteristics, notably that mortality rates increased with aortic coverage exceeding 25 cm.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of TEVAR for thoracic aortic diseases: a retrospective single-center study

Deniz,

Kasımzade,

Ozcınar

et al. 2024

J Cardiothorac Surg

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Background The outcomes of Thoracic Endovascular Aortic Repair (TEVAR) vary depending on thoracic aortic pathologies, comorbidities. This study presents our comprehensive endovascular experience, focusing on exploring the outcome in long term follow-up. Methods From 2006 to 2018, we conducted TEVAR on 97 patients presenting with various aortic pathologies. This retrospective cohort study was designed primarily to assess graft durability and secondarily to evaluate mortality causes, complications, reinterventions, and the impact of comorbidities on survival using Kaplan-Meier and Cox regression analyses. Results The most common indication was thoracic aortic aneurysm (n = 52). Ten patients had aortic arch variations and anomalies, and the bovine arch was observed in eight patients. Endoleaks were the main complications encountered, and 10 of 15 endoleaks were type I endoleaks. There were 18 reinterventions; the most of which was TEVAR (n = 5). The overall mortality was 20 patients, with TEVAR-related causes accounting for 12 of these deaths, including intracranial bleeding in three patients. Multivariant Cox regression revealed chronic renal diseases (OR = 11.73; 95% CI: 2.04–67.2; p = 0.006), previous cardiac operation (OR = 14.26; 95% CI: 1.59-127.36; p = 0.01), and chronic obstructive pulmonary diseases (OR = 7.82; 95% CI: 1.43–42.78; p = 0.001) to be independent risk factors for 10-year survival. There was no significant difference in the survival curves of the various aortic pathologies. In the follow-up period, two non-symptomatic intragraft thromboses and one graft infection were found. Conclusion Comorbidities can increase the risk of TEVAR-related mortality without significantly impacting endoleak rates. TEVAR is effective for severe aortic pathologies, though long-term graft durability may be compromised by its thrombosis and infection.

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Applicability of ASA classification system in elective endovascular aneurysm repair

Cited by 4 publications

References 0 publications

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

Long-Term Outcomes of TEVAR for Thoracic Aortic Diseases: A Retrospective Single-Center Study

Long-term outcomes of TEVAR for thoracic aortic diseases: a retrospective single-center study

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