Endovascular aneurysm repair (EVAR) follow-up imaging: the assessment and treatment of common postoperative complications

Ilyas, Shahzad; Shaida, Nadeem; Thakor, Avnesh S.; Winterbottom, Andrew; Cousins, Claire

doi:10.1016/j.crad.2014.09.010

Cited by 35 publications

(30 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EVAR always has better short-term outcomes compared with open repair [ 2 , 3 ]. Aortic endograft occlusion, migration, and endoleaks are known complications after EVAR [ 4 ], among which endoleaks are the most frequent. Types I and III endoleaks require urgent intervention to relieve aneurysm re-pressurization [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis

Guo

Zhao

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

ObjectivesThis systematic review and meta-analysis aims to determine the current evidence on risk factors for type II endoleaks after endovascular aneurysm repair (EVAR).Materials and methodsA systematic literature search was carried out for studies that evaluated the association of demographic, co-morbidity, and other patient-determined factors with the onset of type II endoleaks. Pooled prevalence of type II endoleaks after EVAR was updated.ResultsAmong the 504 studies screened, 45 studies with a total of 36,588 participants were included in this review. The pooled prevalence of type II endoleaks after EVAR was 22% [95% confidence interval (CI), 19%–25%]. The main factors consistently associated with type II endoleaks included age [pooled odds ratio (OR), 0.37; 95% CI, 0.31–0.43; P<0.001], smoking (pooled OR, 0.71; 95% CI, 0.55–0.92; P<0.001), patent inferior mesenteric artery (pooled OR, 1.98; 95% CI, 1.06–3.71; P = 0.012), maximum aneurysm diameter (pooled OR, 0.23; 95% CI, 0.17–0.30; P<0.001), and number of patent lumbar arteries (pooled OR, 3.07; 95% CI, 2.81–3.33; P<0.001). Sex, diabetes, hypertension, anticoagulants, antiplatelet, hyperlipidemia, chronic renal insufficiency, types of graft material, and chronic obstructive pulmonary diseases (COPD) did not show any association with the onset of type II endoleaks.ConclusionsClinicians can use the identified risk factors to detect and manage patients at risk of developing type II endoleaks after EVAR. However, further studies are needed to analyze a number of potential risk factors.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis

Guo

Zhao

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…1 Endovascular aortic aneurysm repair (EVAR) requires CA for the preinterventional computed tomography (CT), during the procedure and the follow-up period when using CT. 2 Clinical assessment of kidney function is a routine practice pre-EVAR because the incidence of acute kidney injury after EVAR is significant and is independently associated with medium-term mortality and morbidity. 3,4 The complete blood count, a readily available, routine examination, has been considered as an indicator of CIN in cardiology patients.…”

mentioning

confidence: 99%

Full Blood Count as a Potential Predicting Factor of Contrast-Induced Nephropathy After Endovascular Aortic Aneurysm Repair

2016

View full text Add to dashboard Cite

Contrast-induced nephropathy (CIN) is an important adverse effect of administration of intravenous contrast agent (CA) associated with prolonged hospitalization as well as increased cardiovascular and renal morbidity and all-cause mortality. 1 Several risk factors can predict CIN incidence, and various scores have been proposed to identify high-risk patients prior to CA exposure. 1 Endovascular aortic aneurysm repair (EVAR) requires CA for the preinterventional computed tomography (CT), during the procedure and the follow-up period when using CT. 2 Clinical assessment of kidney function is a routine practice pre-EVAR because the incidence of acute kidney injury after EVAR is significant and is independently associated with medium-term mortality and morbidity. 3,4 The complete blood count, a readily available, routine examination, has been considered as an indicator of CIN in cardiology patients. [5][6][7] The neutrophil to lymphocyte ratio, 5 platelet to lymphocyte ratio, 6 and red cell distribution width 7 have been suggested as predictors of CIN in patients undergoing cardiologic interventional procedure. Considering the common pathway between pathophysiology and risk profiles in coronary artery disease and abdominal aortic aneurysm, 8 we suggest that a complete blood count could be used to identify patients who are at high risk of CIN after EVAR.Future prospective studies should assess the potential usefulness of the complete blood count in the identification of patients at high risk to develop post-EVAR CIN. This may guide the need for intense preprocedural preventive strategy.

show abstract

“…In addition, endovascular treatment for rAAA has shown an increasing trend [ 10 – 12 ]. Despite these advances, the treatment of aneurysms in emergency departments is still a challenge, especially in developing countries, because of the lack of supplies or equipment [ 13 ]. Therefore, OSR provides a suitable alternative as it does not require intravascular stent and detailed measurements of aneurysm.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative renal dysfunction following open surgical repair of abdominal aortic aneurysms retrospective analysis

Yuan

Zhao

et al. 2017

Oncotarget

View full text Add to dashboard Cite

ObjectivesTo identify the risk factors for postoperative renal dysfunction after open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) and to establish a scoring system.ResultsThe overall 30-day mortality rates were 22.0%(ruptured) vs 2.6% (unruptured), respectively. For the ruptured group, the independent risk factors were hemodynamic instability (P = 0.002) blood loss >1 L (P = 0.041) and preoperative creatinine >150 μmol/L (P < 0.001). By contrast, for the unruptured group, factors were smoking (P = 0.028), blood loss >1 L (P = 0.018), and antihypertensive drugs (P < 0.001). The areas under the curve of the WCRDA scoring system are 0.794 (95% confidence interval (CI) 0.686–0.902, P < 0.001) and 0.811 (95% CI 0.691–0.932, P < 0.001) for the ruptured and unruptured groups, respectively.ConclusionsHemodynamic instability, blood loss >1 L and Hb <90 g/L are independent risk factors for postoperative renal dysfunction following rAAA OSR, whereas smoking, blood loss >1 L, and antihypertensive drugs are independent risk factors. WCRDA performs well in predicting postoperative renal dysfunction.Materials and Methods287 patients from the Vascular Department of West China Hospital, Sichuan University, who were planned to perform OSR for AAA from November 2003 to January 2017. 274 patients underwent OSR for AAA were finally included in the study. A total of 118 patients had ruptured AAA and 156 unruptured AAA.The patients were divided into the ruptured and unruptured groups. Logistic regression was used to identify the independent risk factors for postoperative renal dysfunction. The receiver operating characteristic curve was used to evaluate the scoring system.

show abstract

Endovascular aneurysm repair (EVAR) follow-up imaging: the assessment and treatment of common postoperative complications

Cited by 35 publications

References 26 publications

Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis

Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis

Full Blood Count as a Potential Predicting Factor of Contrast-Induced Nephropathy After Endovascular Aortic Aneurysm Repair

Risk factors for postoperative renal dysfunction following open surgical repair of abdominal aortic aneurysms retrospective analysis

Contact Info

Product

Resources

About