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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899

Periodicità: Bimestrale

ISSN 0392-9590

Online ISSN 1827-1839


International Angiology 2015 Nov 23

Impact of preoperative evaluation by vascular physician on mortality in patients undergoing elective endovascular repair for abdominal aortic aneurysm

Nessvi Otterhag S., Gottsäter A., Acosta S.

Vascular Center, Instituion of Clinical Sciences, Malmo, Sweden

AIM: Abdominal aortic aneurysm (AAA) is a potentially life-threatening condition associated with increased cardiovascular mortality. This study aims to evaluate effects of medical assessment prior to endovascular repair (EVAR) for AAA on long term survival and causes of death.
METHODS: A retrospective study comparing patients treated with EVAR for AAA from 1998 to 2006, having undergone standardized preoperative work-up including spirometry and echocardiography (group 1, n=304), to patients undergoing EVAR 2007 to 2011 after individual assessment by a vascular physician aiming to optimize cardiovascular medication and reveal previously unknown illnesses (group 2, n=201). Median follow-up was 84 months (Inter Quartile Range [IQR] 40-84) in group 1, and 60 months (IQR 45-75) in group 2.
RESULTS: The use of lipid lowering agents (92%; p<0.001), anti-platelet (85%; p<0.001), antihypertensive drugs (94%; p<0.001), and beta receptor blockers (78%; p<0.001) was higher in group 2. In multivariable analysis adjusting for AAA-size ≥ 6.0 cm, signs of ischemia on ECG, and chronic kidney disease stage ≥ 3, group 1 had significantly higher both 1-year (OR 3.2 [95% CI 1.2-9.0]) and 2-year mortality (OR 2.3 [95% CI 1.2 – 4.6]), whereas no differences were found between groups in survival beyond 2 years. Vascular disease was the most common cause of death in both groups (62% and 55%; p=0.29).
CONCLUSION: Individualized preoperative evaluation by a vascular physician prior to elective EVAR was associated with reduced 1- and 2-year mortality, presumably related to more effective pharmacological cardiovascular prevention.

lingua: Inglese


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