Higher 30 Day Mortality in Patients with Familial Abdominal Aortic Aneurysm after EVAR

K.M. van de Luijtgaarden, F. Bastos Gonçalves, S.E. Hoeks, J.D. Blankensteijn, D. Böckler, R.J. Stolker, H.J.M. Verhagen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives To determine the influence of a positive family history for aneurysms on clinical success and mortality after endovascular aneurysm repair (EVAR). Methods From 2009 to 2011, 1262 patients with abdominal aortic aneurysms (AAA) treated by EVAR were enrolled in a prospective, industry sponsored clinical registry ENGAGE. Patients were classified into familial and sporadic AAA patients according to baseline clinical reports. Clinical characteristics, aneurysm morphology, and follow-up were registered. The primary endpoint was clinical success after EVAR, a composite of technical success and freedom from the following complications: AAA increase >5 mm, type I and III endoleak, rupture, conversion, secondary procedures, migration, and occlusion. Secondary endpoints were the individual components of clinical success, 30 day mortality, and aneurysm related and all cause mortality. Results Of the 1262 AAA patients (89.5% male and mean age 73.1 years), 86 patients (6.8%) reported a positive family history and were classified as familial AAA. Duration of follow-up was 4.4 ± 1.7 years. Patients with familial AAA were more often female (18.6% vs. 9.9%, p =.012). No difference was observed in aneurysm morphology. There was no significant difference in clinical success between patients with familial and sporadic AAA (72.1% vs. 79.3%, p=.116). Familial AAA patients had a higher 30 day mortality after EVAR (4.7% vs. 1.0%, adjusted HR 5.7, 1.8–17.9, p =.003) as well as aneurysm related mortality (5.8% vs. 1.3%, adjusted HR 5.4, 1.9–14.9, p =.001), while no difference was observed in all cause mortality (19.8% vs. 24.3%, adjusted HR 0.8, 0.5–1.4, p =.501). Conclusions The current study shows a higher 30 day mortality after EVAR in familial AAA patients. Future studies should determine the role of family history in AAA treatment, suitability for endovascular or open repair, and on adaptation of post-operative surveillance. For the time being, patients with familial forms of AAA should be considered at higher risk for EVAR and warrant extra vigilance. © 2017 European Society for Vascular Surgery
Original languageEnglish
Pages (from-to)142-149
Number of pages8
JournalEuropean Journal Of Vascular And Endovascular Surgery
Volume54
Issue number2
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Abdominal aortic aneurysm
  • Familial abdominal aortic aneurysm
  • Post-operative mortality
  • abdominal aortic aneurysm
  • aged
  • aneurysm rupture
  • Article
  • clinical feature
  • device migration
  • endoleak
  • endovascular aneurysm repair
  • familial disease
  • family history
  • female
  • follow up
  • graft occlusion
  • human
  • kidney failure
  • major clinical study
  • male
  • morphology
  • mortality
  • postoperative complication
  • priority journal
  • register
  • stent graft
  • systolic blood pressure

Fingerprint Dive into the research topics of 'Higher 30 Day Mortality in Patients with Familial Abdominal Aortic Aneurysm after EVAR'. Together they form a unique fingerprint.

Cite this