TY  - BOOK
AU  - Hynes, Conor F
TI  - Reoperation rates after open and endovascular abdominal aortic aneurysm repairs
SN  - 0741-5214
PY  - 2017///
KW  - *Aortic Aneurysm, Abdominal/su [Surgery]
KW  - *Blood Vessel Prosthesis Implantation/ae [Adverse Effects]
KW  - *Endovascular Procedures/ae [Adverse Effects]
KW  - *Postoperative Complications/su [Surgery]
KW  - Aged
KW  - Aortic Aneurysm, Abdominal/dg [Diagnostic Imaging]
KW  - Databases, Factual
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Postoperative Complications/dg [Diagnostic Imaging]
KW  - Quality Indicators, Health Care
KW  - Reoperation
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - United States
KW  - United States Department of Veterans Affairs
KW  - MedStar Washington Hospital Center
KW  - Surgery/General Surgery
KW  - Comparative Study
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: The long-term burden of reoperations after OR may actually be more significant than current understanding when including all possible abdominal complications in an extended analysis. Future prospective trials should include all potential reoperations extended >30 days with associated cost analysis. As surgical innovation in EVAR technology advances, complication comparisons with OR should undergo frequent re-evaluation given that endovascular indications and outcomes continue to expand and improve; Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved; METHODS: A retrospective review of the Veterans Affairs Surgical Quality Improvement Project data was performed with inclusion criteria defined as all patients who underwent AAA repair from October 1, 2007, to October 1, 2013. The primary outcome was the incidence of reoperations. Reoperations included subsequent OR or EVAR procedures performed on the abdominal aorta or iliac arteries, surgical treatment of temporally related bowel obstruction, as well as treatment of abdominal or groin wound complications <=6 months and treatment of bowel or lower limb ischemia <=10 days; OBJECTIVE: This study compared reoperation rates associated with open abdominal aortic aneurysm (AAA) repair (OR) outcomes vs endovascular AAA repair (EVAR); RESULTS: Of 6677 patients who underwent AAA repair, 476 (7.1%) required reoperations. OR was associated with a higher rate of reoperations overall (10.0% vs 6.3%; P < .01), with most being intra-abdominal and wound complications. OR also had higher rates of bowel ischemia requiring operation (0.7% vs 0.3%; P = .01) and lower extremity ischemia (0.5% and 0.06%; P < .01). Significantly more endovascular stents were placed during EVAR (2.8% vs 0.5%; P < .01). Logistic regression showed EVAR is a negative predictor for reoperation after controlling for comorbidities (P < .001)
UR  - https://dx.doi.org/10.1016/j.jvs.2016.09.053
ER  -