Editor's Choice – Structured Computed Tomography Analysis can Identify the Majority of Patients at Risk of Post-Endovascular Aortic Repair Rupture

• DOI: 10.1016/j.ejvs.2022.04.042
• Publication Date: 2022-05-11T06:50:32Z
• Authors: Mattias Andersson; Charlotte Sandström; Otto Stackelberg; Robert Lundqvist; Joakim Nordanstig; Magnus Jonsson; Joy Roy; Manne Andersson; Rebecka Hultgren; Håkan Roos
• Keywords: Endovascular aneurysm repair; Aortic rupture; Computed Tomography Angiography; Medical record

The main objective was to report mechanisms and precursors for post-endovascular aneurysm repair (EVAR) rupture. second apply a structured protocol explore whether these factors were identifiable on follow up computed tomography (CT) prior third study the incidence, treatment, outcome of post-EVAR rupture.This multicentre, retrospective patients treated with standard EVAR at five Swedish hospitals from 2008 2018. Patients identified Swedvasc registry. Medical records reviewed 2020. Index data recorded. primary endpoint CT rupture studied, using protocol, determine precursors.In 1 805 by EVAR, 45 ruptures occurred in 43 patients. cumulative incidence 2.5% over mean 5.2 years. rate 4.5/1 000 person Median time 4.1 A further six cases found outside cohort included analysis only. mechanism type IA 20 51 (39%), IB (39%) IIIA/B 11 (22%). One had + combined. patient an aortoduodenal fistula without another being identified. Precursors been noted 16 (31%). Retrospectively, could be (84%). In 17 27 (63%) missed but retrospectively identifiable, IB/III. Overall, 30 day mortality after 47% (n = 24/51) post-operative 21% 7/33).Most are underdiagnosed before protocol. III failures caused majority ruptures.