The Impact of the Covid-19 Pandemic on the Outcomes of Acute Vascular Pathologies

Abstract

to 63.1% in 2018 (P ¼ .02). At 1-year follow-up, 32.7% of patients were maintained on DAPT. Patients discharged on DAPT were younger (73.0 vs 74.9 years, P < .001), more often male (80% vs 74.9%, P ¼ .04), and had a higher prevalence of cardiovascular comorbidities: coronary artery disease (36.7% vs 27.5%, P < .001) and prior coronary artery bypass graft or percutaneous coronary intervention (45.2% vs 34.3%, P < .001). Intraoperatively, the DAPT cohort had the same average number of visceral vessels treated (2.8 vs 2.7, P ¼ .09), but had a higher frequency of SMA involvement (70.4% vs 64.0%, P ¼ .02) with a higher proportion of SMA interventions involving snorkels (10.6% vs 7.0%, P ¼ .01). Immediate postoperative outcomes were similar between the two antiplatelet regimens. At 1-year follow up, the two cohorts did not differ in aneurysm size, disease extent, or overall reintervention rate. The DAPT cohort had similar visceral vessel reintervention to the aspirin cohort (4.2% vs 3.5%, P ¼ .54) (Table I). Snorkel treatment and increased number of visceral vessels treated were associated with discharge on DAPT. Increasing age, American Society of Anesthesiologists class 4 or 5, and discharge on anticoagulation were all associated with the decreased likelihood of discharge on DAPT (Table II).Conclusions: These results show an increase in utilization of DAPT after complex endovascular aortic aneurysm surgery involving visceral vessels. DAPT is used more with the snorkel technique and with increased numbers of visceral vessels treated. One-year outcomes including aneurysm size, need for reintervention, and vessel-specific reintervention do not differ based on antiplatelet regimen at discharge.