Effect of patient frailty status on outcomes of fenestrated-branched endovascular aortic repair for complex abdominal and thoracoabdominal aortic aneurysms

Paajanen, Paavo; Kärkkäinen, Jussi M.; Tenorio, Emanuel R.; Mendes, Bernardo C.; Oderich, Gustavo S.

doi:10.1016/j.jvs.2022.05.008

Cited by 12 publications

(4 citation statements)

References 38 publications

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“…The mFI-5 debilitating assessment method used in the study by Hodari et al was based on a single de cit, and was subsequently modi ed by Velanovich et al to the mFI-11, which was based on a cumulative de cit model including 11 simpli ed variables. 20 mFI-11, whose score is calculated in the same way as the cumulative index of defects, with higher scores implying more severe frailty, has been shown to predict neurosurgery, 21,22 thoracic surgery, 23 orthopedic surgery, 24,25 and gastrointestinal tumor resection 26,27 of postoperative outcomes. Compared with the mFI-5, the mFI-11 contains more preoperative comorbidities that may potentially in uence postoperative complications in esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

Risk Stratification Tool for Predicting Postoperative Outcomes in Patients Undergoing Esophagectomy: A Prospective Study

YUAN,

Maimaiti,

et al. 2023

Preprint

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Purpose Frailty, a clinical syndrome characterized by a reduced physiological reserve and decreased resistance to stressors, is extremely common in oncology patients. Given that esophagectomy is associated with significant postoperative adverse outcomes, the early identification of high-risk patients is critical. This study compared the utility of the Modified 5-Factor Frailty Index (mFI-5) and the Modified Charlson Comorbidity Index (mCCI) in predicting postoperative outcomes in patients undergoing esophagectomy. Method We reviewed the records of patients who underwent esophagectomy between 2019 and 2022. Two validated risk stratification tools measured the burden of comorbidity: mFI-5 and mCCI. The primary outcomes included a prolonged postoperative hospital stay and major and minor postoperative complications. Result A total of 359 patients were included (mean age 63.1 ± 8.6 years; 74.4% were males). The length of postoperative hospital stay was 30.0 (IQR 25.0,39.5) days, with 37 patients (10.3%) experiencing major postoperative complications and 192 patients (53.5%) experiencing minor postoperative complications. In multivariate analysis, mCCI remained a significant predictor of major postoperative complications (OR = 1.52, 95% CI 1.01–2.3, p = 0.046), but was no longer a significant predictor of prolonged postoperative hospital stay or minor complications. In addition, the mFI-5 score was no longer a significant predictor of any of the three postoperative outcomes. Conclusion This is the first study to compare the utility of the mFI-5 and mCCI in predicting adverse postoperative outcomes in patients undergoing esophagectomy. Our findings suggest that mCCI is a valid predictor of major complications in this patient group, whereas the role of mFI-5 is limited. This should be further investigated in a prospective multicenter cohort study.

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Section: Discussionmentioning

confidence: 99%

Risk Stratification Tool for Predicting Postoperative Outcomes in Patients Undergoing Esophagectomy: A Prospective Study

YUAN,

Maimaiti,

et al. 2023

Preprint

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“…Images should be input into a software capable of reconstruction using the centerline of flow, enabling accurate measurement of distances, anatomy of target vessels, aortic size, and angulation. The paramount parameter that should be assessed is the proximal landing zone (PLZ) to certify that attachment sites are free from calcification and thrombus in a healthy aortic segment with suitable angulation [2,39] . A proximal landing zone of at least 25 mm is necessary for durable endovascular repair.…”

Section: Selection Of Branches or Fenestrationsmentioning

confidence: 99%

“…A proximal landing zone of at least 25 mm is necessary for durable endovascular repair. Anatomic contraindications to the procedure, such as multiple small-diameter target arteries (< 4 mm), excessive angulation, and early bifurcations, should be identified prior to the procedure [2] .…”

Section: Selection Of Branches or Fenestrationsmentioning

confidence: 99%

“…The endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs) continues to evolve over time with novel techniques and devices, expanding the pool of patients eligible for this approach [1] . To successfully repair complex TAAAs, one should take into consideration the anatomy of the patient, clinical characteristics, and the anatomic suitability of each device [2] . Fenestrated and branched grafts have had a crucial role in improving outcomes, allowing treatment for high-risk patients who would not tolerate more invasive procedures [3] .…”

Section: Introductionmentioning

confidence: 99%

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Current state of endovascular repair of thoracoabdominal aortic aneurysms

Rodrigues,

Lima,

DeMartino

et al. 2024

Vessel Plus

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Thoracoabdominal aortic aneurysm (TAAA) is a severe and complex condition with multifactorial etiology that can lead to life-threatening complications. Its treatment is genuinely complex irrespective of the chosen technique, open or endovascular repair. Fenestrated-branched endovascular aneurysm repair (F/B-EVAR) has been increasingly accepted in patients with suitable anatomy, resulting in outcomes compared to or superior to open repair. The selection of patients, judicious surgical planning, and device selection are paramount to achieving successful treatment. The field of TAAA repair is continuously evolving with ongoing research and the development of new techniques and devices to further improve patient outcomes. This paper aims to present a review of endovascular TAAA treatment, summarizing anatomical and clinical features relevant to technical performance and treatment indications.

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Effect of Sarcopenia on Mortality and Spinal Cord Ischaemia After Complex Aortic Aneurysm Repair: Systematic Review and Meta-Analysis

Nana

Σπανός

Brotis

et al. 2023

European Journal of Vascular and Endovascular Surgery

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Effect of patient frailty status on outcomes of fenestrated-branched endovascular aortic repair for complex abdominal and thoracoabdominal aortic aneurysms

Cited by 12 publications

References 38 publications

Risk Stratification Tool for Predicting Postoperative Outcomes in Patients Undergoing Esophagectomy: A Prospective Study

Risk Stratification Tool for Predicting Postoperative Outcomes in Patients Undergoing Esophagectomy: A Prospective Study

Current state of endovascular repair of thoracoabdominal aortic aneurysms

Effect of Sarcopenia on Mortality and Spinal Cord Ischaemia After Complex Aortic Aneurysm Repair: Systematic Review and Meta-Analysis

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