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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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THORACIC AND ABDOMINAL AORTA  20 YEARS EVC: MANAGEMENT OF ARTERIAL DISEASES


The Journal of Cardiovascular Surgery 2016 Aprile;57(2):242-7

lingua: Inglese

Towards individualized follow-up protocols after endovascular aortic aneurysm repair

Johanna LATURNUS 1, Nelson OLIVEIRA 2, 3, Frederico BASTO GONÇALVES 2, Geert W. SCHURINK 1, 4, Hence VERHAGEN 3, Michael J. JACOBS 1, 4, Barend M. E. MEES 1, 4

1 Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; 2 Department of Angiology and Vascular Surgery, Santa Marta Hospital, Nova Medical School, Lisbon, Portugal; 3 Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands; 4 European Vascular Center Aachen-Maastricht, The Netherlands


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Endovascular aneurysm repair (EVAR) has become the primary treatment option for elective abdominal aortic aneurysms. However, a significant number of patients require secondary interventions to maintain adequate aneurysm exclusion and ultimately prevent death from abdominal aortic aneurysm (AAA) rupture. To maintain success and offer timely secondary intervention, intensive image surveillance has been recommended. These rigorous surveillance regimens are costly and may have deleterious effects from radiation and contrast exposure. Improvements in patient selection, operative technique and devices have caused a decline in complications after EVAR. Therefore, there is a need to reduce surveillance after EVAR for patients at lower risk of complications and install individualized follow-up protocols. This review describes the current strategies for surveillance and clarification of risk factors and predictors for late complications and discusses proposed risk-adapted strategies for postoperative surveillance after EVAR.

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barend.mees@mumc.nl