Study: Decreased complication among EVAR conversion patients anticipated when managed at high-volume aortic centers

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Endovascular aortic aneurysm repair (EVAR) conversion to open aortic repair (OAR) is now an increasingly common indication and associated with greater operative complexity. However, “decreased complication risk and comparable survival can be anticipated when patients are managed at high-volume aortic referral centers,” a new study to be presented during a scientific session on June 25 will show.

Presenting author Christopher Jacobs, MD, of the University of Florida in Gainesville, Florida, is set to present data from an 18-year retrospective review of all open repair procedures performed at a single academic medical center.

Jacobs et al conducted the study against the backdrop of what they described as a paucity of data “highlighting the evolution of peri- procedural results surrounding EVAR conversion and changes in practice patterns, especially for referral centers that increasingly manage EVAR failures due to care regionalization.”

They set out to perform a temporal analysis of their center’s experience with conversion to open repair and describe changes in patient selection, operative details and outcomes.

The data deployed was drawn from between the period 2002–2019. EVAR conversion patients (184) were categorized into three eras: 2002–2009 (21), 2010–2014 (67) and 2015–2019 (96).

The study detected a significant increase in EVAR conversion as an indication for OAR (p-trend<0.001).

The authors further concluded: “In an era of diminishing OAR volumes, these findings underscore growing concerns surrounding competency and proficiency in aortic surgery.”

This further emphasized the need to develop comprehensive specialty- wide and procedure-specific initiatives to optimize appropriate and balanced use of EVAR and OAR in the management of AAAs [abdominal aortic aneurysms] nationally, the investigators added.

WHEN: Thursday, June 25, 2020, 1:10 p.m.–1:15 p.m. Scientific Session 3

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