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• W4210366418 abstract "INTRODUCTION There are currently six endovascular stent grafts approved by the Food and Drug Administration for the endovascular repair (EVAR) of infra-renal abdominal aortic aneurysms (AAA). There is minimal data comparing the outcomes between devices. METHODS The National Surgical Quality Improvement Program (NSQIP) targeted database was queried for patients undergoing EVAR between 2011-2019. Devices used in at least 10% of patients were included (Cook Zenith, Gore Excluder, and Medtronic Endurant). Patient demographics, procedure details, 30-day EVAR specific complications and mortality were compared between devices. Multivariable logistic regression models were used to predict outcomes while adjusting for baseline differences between device cohorts. RESULTS 13,416 patients were included. Most patients underwent repair with a Gore Excluder (5,997; 44.7%). There was no difference in the rates of diabetes, hypertension, or end-stage renal disease between cohorts. Unadjusted outcomes are shown in Table 1. The rate of postoperative acute limb ischemia (ALI) was higher in overall patients who underwent repair with a Medtronic Endurant, as well as in subgroup analysis of patients with ruptured AAA. Patients who underwent repair with a Medtronic Endurant were more likely than those who underwent repair with a Gore Excluder (OR=2.06; 95%CI=1.49-2.86) or with a Cook Zenith device (OR=1.56; 95%CI=1.06-2.28), to have postoperative ALI. No differences between devices were associated with death, MACE, ischemic colitis, conversion to open or postoperative dialysis. CONCLUSION Overall, safety is similar among major endovascular stent grafts for EVAR, except for a higher rate of ALI following repairs with the Medtronic Endurant. Since with this study we cannot determine if the higher incidence of ALI relates to graft design, patient anatomy, or operative technique, future studies should be aimed to further evaluate this finding. There are currently six endovascular stent grafts approved by the Food and Drug Administration for the endovascular repair (EVAR) of infra-renal abdominal aortic aneurysms (AAA). There is minimal data comparing the outcomes between devices. The National Surgical Quality Improvement Program (NSQIP) targeted database was queried for patients undergoing EVAR between 2011-2019. Devices used in at least 10% of patients were included (Cook Zenith, Gore Excluder, and Medtronic Endurant). Patient demographics, procedure details, 30-day EVAR specific complications and mortality were compared between devices. Multivariable logistic regression models were used to predict outcomes while adjusting for baseline differences between device cohorts. 13,416 patients were included. Most patients underwent repair with a Gore Excluder (5,997; 44.7%). There was no difference in the rates of diabetes, hypertension, or end-stage renal disease between cohorts. Unadjusted outcomes are shown in Table 1. The rate of postoperative acute limb ischemia (ALI) was higher in overall patients who underwent repair with a Medtronic Endurant, as well as in subgroup analysis of patients with ruptured AAA. Patients who underwent repair with a Medtronic Endurant were more likely than those who underwent repair with a Gore Excluder (OR=2.06; 95%CI=1.49-2.86) or with a Cook Zenith device (OR=1.56; 95%CI=1.06-2.28), to have postoperative ALI. No differences between devices were associated with death, MACE, ischemic colitis, conversion to open or postoperative dialysis. Overall, safety is similar among major endovascular stent grafts for EVAR, except for a higher rate of ALI following repairs with the Medtronic Endurant. Since with this study we cannot determine if the higher incidence of ALI relates to graft design, patient anatomy, or operative technique, future studies should be aimed to further evaluate this finding." @default.
• W4210366418 created "2022-02-08" @default.
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• W4210366418 date "2022-02-01" @default.
• W4210366418 modified "2023-09-27" @default.
• W4210366418 title "Perioperative Outcomes Among Major Endovascular Stent Grafts For The Treatment Of Abdominal Aortic Aneurysm" @default.
• W4210366418 doi "https://doi.org/10.1016/j.avsg.2021.12.066" @default.
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