Perioperative Mortality and the Long-Term Outcome of Endovascular Abdominal Aneurysm Repair (EVAR): A Single-Centre Experience

Mohamed S M Elshikhawoda; Muhammad Numan Zahid; Steven H S Tan; Ahmed Hashim Ahmed Mohamed; Doaa Abdalaziz Salih Abdalaziz; Ali Yasen Y Mohamedahmed; Sohaib Jararaa; Mahmoud Okaz; Abdelrhman Elsanosi; Hassan Jararah

doi:10.7759/cureus.49260

Perioperative Mortality and the Long-Term Outcome of Endovascular Abdominal Aneurysm Repair (EVAR): A Single-Centre Experience

Cureus. 2023 Nov 22;15(11):e49260. doi: 10.7759/cureus.49260. eCollection 2023 Nov.

Affiliations

¹ Vascular and Endovascular Surgery, Glan Clwyd Hospital, Rhyl, GBR.
² Vascular and Endovascular surgery, Glan Clwyd Hospital, Rhyl, GBR.
³ Surgery, University Hospital of Wales, Cardiff, GBR.
⁴ General Surgery, Faculty of Medicine, The National Ribat University, Khartoum, SDN.
⁵ General Surgery, University Hospital of North Tees, Stock-on-Tees, GBR.
⁶ General Surgery, The Royal Wolverhampton National Health Service (NHS) trust, Wolverhampton, GBR.
⁷ Vascular Surgery, Glan Clwyd Hospital, Rhyl, GBR.
⁸ Vascular Surgery, University Hospital Hairmyres, Scotland, GBR.

Abstract

Background Abdominal aortic aneurysm (AAA) is a dangerous disorder characterised by abnormal enlargement of the abdominal aorta. The severity of the aneurysm and the presence of symptoms determine the necessary monitoring or treatment to prevent potential fatalities. The objective of this study is to estimate the perioperative mortality and long-term outcome of endovascular abdominal aneurysm repair (EVAR). Patients and methods This is a descriptive, retrospective, observational study. We retrieved the data of the AAA patients who underwent EVAR at Glan Clwyd Hospital from January 2015 to January 2023. The study sample consisted of patients diagnosed with isolated AAA, with or without iliac branch involvement, who were deemed suitable for EVAR based on factors such as advanced age, presence of comorbidities, the complexity of the condition, history of prior surgery, fulfillment of indication criteria, and patient desire. The data was analysed using SPSS statistical software, version 21.0 (IBM Corp., Armonk, NY). Results Two hundred and twenty-two patients were studied. The outcome of the EVAR among the patients was endo-leak 28.4% (n = 63); migration 1.4% (n = 3); blockage 0.5% (n = 1); infolding 0.5% (n = 1); perioperative mortality 1.4% (3); and other complications like access site or acute kidney injury were 1.4% (n = 3). However, no complications were reported in most of the patients, 66.7% (n = 148). Upon evaluating the variables that could affect the outcome, we observed that the ASA grade, comorbidities, and the indication of the intervention had a significant effect on the outcome (P values = 0.000, 0.048, and 0.014, respectively). Conclusion The findings demonstrate that when EVAR is performed by a skilled team adhering to proper criteria, the results are optimal. The mortality rate during the perioperative period was 1.4%. Furthermore, we have shown a satisfactory rate of complications when compared to international data.

Keywords: abdominal aortic aneurysm; endo-leak; endovascular aortic aneurysm repair; endovascular aortic repair; evar complications; perioperative mortality.