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Aortic dilatation after endovascular repair of blunt traumatic thoracic aortic injuries.

https://arctichealth.org/en/permalink/ahliterature143862
Source
J Vasc Surg. 2010 Jul;52(1):45-8
Publication Type
Article
Date
Jul-2010
Author
Thomas L Forbes
Jeremy R Harris
D Kirk Lawlor
Guy Derose
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre & The University of Western Ontario, London, Ontario, Canada. Tom.Forbes@lhsc.on.ca
Source
J Vasc Surg. 2010 Jul;52(1):45-8
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aorta, Thoracic - injuries - radiography - surgery
Aortic Aneurysm, Thoracic - etiology - radiography
Aortography - methods
Blood Vessel Prosthesis Implantation - adverse effects
Dilatation, Pathologic
Humans
Middle Aged
Ontario
Thoracic Injuries - radiography - surgery
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Wounds, Nonpenetrating - radiography - surgery
Young Adult
Abstract
Endovascular repair of blunt traumatic thoracic aortic injuries (BTAI) has become routine at many trauma centers despite concerns regarding durability and aortic dilatation in these predominantly young patients. These concerns prompted this examination of thoracic aortic expansion after endovascular repair of a BTAI.
The immediate postoperative and most recent computed tomography (CT) scans of patients who had undergone urgent endovascular repair of a BTAI and had at least 1 year of follow-up were reviewed. Diameter measurements were made at four predetermined sites: immediately proximal to the left subclavian artery (D1), immediately distal to the left subclavian artery (D2), distal extent of the endograft (D3), and 15 mm beyond the distal end of the endograft (D4). Split screens permitted direct comparison of measurements between CTs at the corresponding levels.
During a 6-year period (2001-2007), 21 patients (mean age, 42.9 years; range, 19-81 years) underwent endovascular repair of a BTAI, 17 with at least 1 year of follow-up (mean, 2.6 years; range, 1-5.5 years). No patients required reintervention during this period. The mean rate of dilatation for each level of the thoracic aorta in mm/year was: D1, 0.74 (95% confidence interval [CI], 0.42-1.06); D2, 0.83 (95% CI, 0.55-1.11); D3, 0.63 (95% CI, 0.37-0.89); D4, 0.47 (95% CI, 0.27-0.67). The rate of expansion of D2 differed significantly vs D4 (P = .025).
During the first several years of follow-up, the proximal thoracic aorta dilates minimally after endovascular repair of BTAIs, with the segment just distal to the left subclavian artery expanding at a slightly greater rate. Longer-term follow-up is necessary to determine whether this expansion continues and becomes clinically significant.
PubMed ID
20434299 View in PubMed
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The association between a surgeon's learning curve with endovascular aortic aneurysm repair and previous institutional experience.

https://arctichealth.org/en/permalink/ahliterature165335
Source
Vasc Endovascular Surg. 2007 Feb-Mar;41(1):14-8
Publication Type
Article
Author
Thomas L Forbes
Guy DeRose
D Kirk Lawlor
Kenneth A Harris
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre & The University of Western Ontario, 800 Commissioners Road E., E2-119, London, ON, Canada. Tom.Forbes@lhsc.on.ca
Source
Vasc Endovascular Surg. 2007 Feb-Mar;41(1):14-8
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - statistics & numerical data
Aged
Aortic Aneurysm, Abdominal - pathology - surgery
Blood Vessel Prosthesis Implantation - education - statistics & numerical data
Clinical Competence
Cohort Studies
Education, Medical, Graduate
Female
Humans
Male
Ontario - epidemiology
Postoperative Complications - epidemiology - etiology
Prospective Studies
Prosthesis Design
Registries
Reoperation - statistics & numerical data
Surgical Procedures, Elective - statistics & numerical data
Time Factors
Treatment Outcome
Abstract
The purpose of the present study was to determine whether an institution's prior endovascular experience influenced the learning curve of subsequent surgeons. A prospective analysis of the initial 70 endovascular abdominal aortic aneurysm repair (EVAR) cases attempted by an individual surgeon was performed with the primary outcome variable being achievement and 30-day maintenance of initial clinical success. Along with standard statistical analyses, the cumulative sum failure method (CUSUM) was used to analyze the learning curve, with a predetermined acceptable failure rate of 10%. Seventy elective EVAR cases were performed by this surgeon during a 4-year period (2000-2004) (mean age, 73.7 -/+ 5.4 years; mean aneurysm diameter 63.3 -/+ 7.2 mm). Initial clinical success was achieved in 68 of 70 cases (97%), which differed significantly with that of our initial surgeon (88.5%, P = .01). Causes of failure in the present series included 1 early mortality (1.4%) and 1 case of conversion to open repair with no instances of type I endoleak or endograft limb thrombosis. Both surgeons' cases were plotted sequentially with CUSUM curves revealing a significantly shorter learning curve for the second surgeon. Optimal results were achieved following 10 to 20 EVAR cases, as opposed to 60 cases in the initial series. Such an analysis confirms that as an institution's experience with EVAR increases, an individual surgeon's learning curve shortens considerably.
PubMed ID
17277238 View in PubMed
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A cost-effectiveness analysis of standard versus endovascular abdominal aortic aneurysm repair.

https://arctichealth.org/en/permalink/ahliterature187245
Source
Can J Surg. 2002 Dec;45(6):420-4
Publication Type
Article
Date
Dec-2002
Author
Thomas L Forbes
Guy DeRose
Stewart Kribs
Kenneth A Harris
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre, University of Western Ontario, London, Ont. Tom.Forbes@lhsc.on.ca
Source
Can J Surg. 2002 Dec;45(6):420-4
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Aortic Aneurysm, Abdominal - economics - surgery
Blood Vessel Prosthesis Implantation - economics
Cost-Benefit Analysis
Hospital Costs
Humans
Ontario
Retrospective Studies
Vascular Surgical Procedures - economics
Abstract
To compare endovascular and standard open repair of abdominal aortic aneurysms in terms of initial in-hospital costs and the costs of secondary interventions and surveillance.
A retrospective study.
A university-affiliated tertiary care medical centre.
Seven patients who underwent elective endovascular (EV) repair of an abdominal aortic aneurysm in 1998 and 31 patients anatomically suitable for endovascular repair who underwent standard (STAN) elective repair. Follow-up ranged from 2 to 14 months.
Elective repair of an abdominal aortic aneurysm with use of the standard technique or endovascular technology.
Costs common to both groups were not determined. Costs were determined for total hospital stay, preoperative or postoperative embolization, grafts, additional endovascular equipment, and follow-up computed tomography.
Groups were similar with respect to demographic data and aneurysm size (EV = 6.23 cm v. STAN = 6.05 cm). All patients were in American Society of Anesthesiologists class III or IV. Vanguar bifurcated grafts and extensions were used in the EV group. The total cost for both groups in Canadian dollars included: cost of stay (EV, 5.6 d, $2092.63 v. STAN, 10.7 d, $4449.19; p = 0.009); cost of embolization (EV, n = 3; $900/procedure); cost of follow-up CT (EV, 5.4 per patient; $450/CT); cost of grafts (EV = $8571.43, STAN = $374); additional radiologic equipment costs (EV = $1475). The mean total cost differed significantly between the 2 groups (EV = $14,967.63 v. STAN = $4823.19; p = 0.004). The additional cost associated with a reduction in hospital stay was calculated by determining the incremental cost-effectiveness ratio (ICER, difference in mean costs/difference in mean length of stay = $1604.51).
Endovascular repair continues to be more expensive than standard open repair determined according to procedural and follow-up costs. The technology is still in the developmental stage, but as it evolves and follow-up protocols are streamlined, it is hoped that there will be an eventual reduction in the costs associated with the endovascular procedure.
PubMed ID
12500916 View in PubMed
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Determination of patient preference for location of elective abdominal aortic aneurysm surgery.

https://arctichealth.org/en/permalink/ahliterature114793
Source
Vasc Endovascular Surg. 2013 May;47(4):288-93
Publication Type
Article
Date
May-2013
Author
John H Landau
Teresa V Novick
Luc Dubois
Adam H Power
Jeremy R Harris
Guy Derose
Thomas L Forbes
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre & Western University, London, Ontario, Canada.
Source
Vasc Endovascular Surg. 2013 May;47(4):288-93
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - diagnosis - mortality - surgery
Catchment Area (Health)
Female
Health Care Surveys
Health Services Accessibility
Hospitals, High-Volume
Hospitals, Low-Volume
Humans
Male
Ontario
Outcome and Process Assessment (Health Care)
Patient Preference
Quality Indicators, Health Care
Questionnaires
Risk assessment
Risk factors
Surgical Procedures, Elective
Treatment Outcome
Vascular Surgical Procedures - adverse effects - mortality
Abstract
Aneurysm repair is centralized in higher volume centers resulting in reduced mortality, with longer travel distances. The purpose of this study is to explore patients' preference between local care versus longer distances and lower mortality rates.
Patients with abdominal aortic aneurysm (AAA) measuring 4 to 5 cm and living at least a 1-hour drive from our hospital were asked to assume it had grown to 5.5 cm, and repair was recommended with a mortality risk of 2%. The level of additional risk they would accept to undergo surgery locally was determined.
A total of 67 patients were surveyed. If mortality risk was equivalent at the local and regional hospitals, 44% preferred care at our tertiary center, while 56% preferred surgery locally. If perioperative mortality was increased at the local hospital, 9% preferred local surgery.
The vast majority of patients with AAA will accept longer travel distances for care as long as it results in a reduction in perioperative mortality.
PubMed ID
23579366 View in PubMed
Less detail

Early mortality following endovascular versus open repair of ruptured abdominal aortic aneurysms.

https://arctichealth.org/en/permalink/ahliterature141805
Source
Vasc Endovascular Surg. 2010 Nov;44(8):645-9
Publication Type
Article
Date
Nov-2010
Author
Ryaz B Chagpar
Jeremy R Harris
D Kirk Lawlor
Guy DeRose
Thomas L Forbes
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre and The University of Western Ontario, London, ON, Canada.
Source
Vasc Endovascular Surg. 2010 Nov;44(8):645-9
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aortic Aneurysm, Abdominal - blood - mortality - physiopathology - surgery
Aortic Rupture - blood - mortality - physiopathology - surgery
Blood pressure
Blood Vessel Prosthesis Implantation - mortality
Consciousness
Endovascular Procedures - mortality
Female
Hemoglobins - metabolism
Humans
International Normalized Ratio
Male
Odds Ratio
Ontario
Patient Selection
Retrospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Urea - blood
Abstract
To determine whether endovascular repair (EVAR) offers a survival advantage over open repair (OAR) with ruptured abdominal aortic aneurysms (RAAA).
Retrospective analysis of RAAA patients treated between 2003 and 2008. Univariate and multivariate analyses were performed.
167 patients presented with RAAA (OAR = 135, 80.8%, EVAR = 32, 19.2%). On univariate analysis, EVAR was associated with a decreased mortality relative to OAR, (15.6% vs 43.7%, P = .004). Patients who survived were younger (P
PubMed ID
20675315 View in PubMed
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Early results from a Canadian multicenter prospective registry of the Endurant stent graft for endovascular treatment of abdominal aortic aneurysms.

https://arctichealth.org/en/permalink/ahliterature127228
Source
J Endovasc Ther. 2012 Feb;19(1):58-66
Publication Type
Article
Date
Feb-2012
Author
Kylie E Kvinlaug
D Kirk Lawlor
Thomas L Forbes
Rod Willoughby
Kent S MacKenzie
Guy DeRose
Marc M Corriveau
Oren K Steinmetz
Author Affiliation
Division of Vascular Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Source
J Endovasc Ther. 2012 Feb;19(1):58-66
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects - instrumentation - mortality
Canada
Endovascular Procedures - adverse effects - instrumentation - mortality
Female
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Postoperative Complications - etiology
Prospective Studies
Prosthesis Design
Registries
Risk assessment
Risk factors
Stents
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Abstract
To report the early results of a multicenter registry of endovascular aneurysm repair (EVAR) using the Endurant stent-graft.
Patients having elective treatment of infrarenal abdominal aortic aneurysm (AAA) with the Endurant stent-graft at 3 Canadian centers were enrolled in a prospective registry between September 2008 and January 2010. In the 16-month period, 111 patients (90 men; mean age 75 years, range 53-93) were registered. Thirty-seven (33.3%) patients had challenging anatomy: short proximal aortic necks (n=17), large diameter (>28 mm) aortic necks (n=4), angulated (>60°) necks (n=3), and small (5 mm, secondary intervention, stent-graft migration, and graft thrombosis.
The overall technical success rate was 100%. Nineteen (17.1%) patients experienced perioperative complications. After a mean follow-up of 6 months (range 0.1-16), mortality in the series was 4.5%: 1 perioperative death (multisystem organ failure) and 4 (3.6%) late deaths (3 cardiac, 1 cancer). Clinical and imaging follow-up past the perioperative period were available in 107 (96.4%) and 99 (89.2%) patients, respectively. Among the latter, 9 (9.1%) had a type II endoleak on the first scan; 4 resolved spontaneously. Three (3.0%) patients developed graft limb thrombosis in follow-up; one required an intervention. There was no graft migration, aneurysm expansion, secondary intervention for endoleak, aneurysm rupture, or conversion.
Early results from this prospective multicenter registry indicate that the Endurant stent-graft is a safe option for elective EVAR in selected AAA patients. Longer follow-up is required to determine the durability of these outcomes.
Notes
Comment In: J Endovasc Ther. 2012 Feb;19(1):67-922313204
PubMed ID
22313203 View in PubMed
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The effect of patient transfer on outcomes after rupture of an abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature164406
Source
Can J Surg. 2007 Feb;50(1):43-7
Publication Type
Article
Date
Feb-2007
Author
Heather Hames
Thomas L Forbes
Jeremy R Harris
D Kirk Lawlor
Guy DeRose
Kenneth A Harris
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre and the University of Western Ontario, London, Ontario, Canada.
Source
Can J Surg. 2007 Feb;50(1):43-7
Date
Feb-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - surgery
Aortic Rupture - mortality - surgery
Female
Hospital Mortality
Hospitalization - statistics & numerical data
Humans
Intensive Care - statistics & numerical data
Length of Stay - statistics & numerical data
Male
Middle Aged
Ontario - epidemiology
Patient Transfer - statistics & numerical data
Referral and Consultation - statistics & numerical data
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome
Abstract
Centralization of vascular surgery services has resulted in patients being transferred longer distances for treatment of life-threatening conditions. The purpose of this study was to determine whether patient transfer adversely affects the survival of people with a ruptured abdominal aortic aneurysm (RAAA).
We performed a retrospective review of all patients undergoing attempted repair of an RAAA at our centre, over a recent 3.5-year period (August 2000-December 2003). Patients were divided into those presenting directly to our centre and those transferred from another hospital. The main outcome variable was in-hospital or 30-day mortality, with secondary variables including time to surgical treatment, mortality in the first 24 hours and length of hospitalization.
Eighty-one patients (73% men) underwent attempted open repair of an RAAA at our centre during this period. Twenty-four patients (29.6%) presented directly to our hospital, while 57 (70.4%) were transferred from another institution. The overall mortality rate was 53%. Although transferred patients took twice as long as direct patients to get to the operating room (6.3 v. 3.2 h, p=0.03), there was no difference in mortality between the 2 groups (50% v. 54%, p=ns). However, deaths of transferred patients were more likely to occur in the first 24 postoperative hours, compared with direct patients (40% v. 33%, p
Notes
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PubMed ID
17391616 View in PubMed
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Endograft treatment of ruptured abdominal aortic aneurysms using the Talent aortouniiliac system: an international multicenter study.

https://arctichealth.org/en/permalink/ahliterature168882
Source
J Vasc Surg. 2006 Jun;43(6):1111-1123; discussion 1123
Publication Type
Article
Date
Jun-2006
Author
Noud Peppelenbosch
Robert H Geelkerken
Chee Soong
Piergiorgio Cao
Oren K Steinmetz
Joep A W Teijink
Mauri Lepäntalo
Jan De Letter
Frank E G Vermassen
Guy DeRose
Erik Buskens
Jaap Buth
Author Affiliation
Catharina Hospital, University Medical Center, 5602 ZA Eindhoven, the Netherlands.
Source
J Vasc Surg. 2006 Jun;43(6):1111-1123; discussion 1123
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Aged
Aneurysm, Ruptured - mortality - surgery
Aortic Aneurysm, Abdominal - mortality - surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - methods - mortality
Canada
Chi-Square Distribution
Europe
Female
Humans
Male
Postoperative Complications
Proportional Hazards Models
Prospective Studies
Statistics, nonparametric
Tomography, X-Ray Computed
Treatment Outcome
Abstract
To understand the potential of endovascular aneurysm repair (EVAR) in patients presenting with a ruptured abdominal aortic aneurysm (rAAA), the proportion in whom this procedure was applicable was assessed. Mortality and morbidity was also determined in patients treated with emergency EVAR (eEVAR) when anatomic and hemodynamic conditions allowed (ie, in the entire cohort with patients receiving endovascular and open repair combined). In addition, a comparison was made between the treatment group with eEVAR and open repair.
Between February 2003 and September 2004, 10 participating institutions enrolled a representative sample of 100 consecutive patients in whom eEVAR was considered. Patients in the New Endograft treatment in Ruptured abdominal aortic Aneurysm (ERA) trial were offered eEVAR or open repair in accordance with their clinical condition or anatomic configuration. Written informed consent was obtained from all patients or their legal representatives. The study included patients who were treated by stent-graft technique or by open surgery in the case of adverse anatomy for endoluminal stent-grafting or severe hemodynamic instability, or both. Data were collated in a centralized database for analysis. The study was sponsored and supported by Medtronic, and eEVAR was uniquely performed with a Talent aortouniiliac (AUI) system in all patients. Crude and adjusted 30-day or in-hospital and 3-month mortality rates were assessed for the entire group as a whole and the EVAR and open repair category separately. Complication rates were also assessed.
Stent-graft repair was performed in 49 patients and open surgery in 51. No significant differences were observed between these treatment groups with regard to comorbidity at presentation, hemodynamic instability, and the proportion of patients who could be assessed by preoperative computed tomography scanning. Patients with eEVAR more frequently demonstrated a suitable infrarenal neck for endovascular repair, a longer infrarenal neck, and suitable iliac arteries for access than patients with open repair. The primary reason to perform open aneurysm repair was an unfavorable configuration of the neck in 80% of the patients. In patients undergoing eEVAR, operative blood loss was less, intensive care admission time was shorter, and the duration of mechanical ventilation was shorter (P
PubMed ID
16765224 View in PubMed
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Examination of the trend in Canada toward geographic centralization of aneurysm surgery during the endovascular era.

https://arctichealth.org/en/permalink/ahliterature171418
Source
Ann Vasc Surg. 2006 Jan;20(1):63-8
Publication Type
Article
Date
Jan-2006
Author
Thomas L Forbes
D Kirk Lawlor
Guy Derose
Kenneth A Harris
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre, The University of Western Ontario, London, Ontario, Canada. tom.forbes@lhsc.on.ca
Source
Ann Vasc Surg. 2006 Jan;20(1):63-8
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Aortic Aneurysm, Abdominal - surgery
Atherectomy
Canada
Chi-Square Distribution
Health Care Costs
Hospitals, University
Humans
Referral and Consultation - trends
Residence Characteristics
Surgical Procedures, Elective - economics - trends
Time Factors
Vascular Surgical Procedures - economics - statistics & numerical data - trends
Abstract
Unlike in the United States, endovascular aneurysm repair (EVAR) has not been widely disseminated in Canada but has remained limited to large-volume vascular surgery units. Since the development of the endovascular program at our hospital, we have experienced a growth in our aneurysm practice and the area of referral. The purpose of this study was to compare the geographic referral area of our aneurysm practice between 1997 (prior to the introduction of EVAR) and 2003 (EVAR and open surgery). Our prospective database was reviewed to identify patients who underwent elective open aneurysm repair in 1997 and 2003 and those who underwent EVAR in 2003. Each patient's county of residence was identified, allowing for grouping of patients into one of four geographic regions (I-IV) increasingly more distant from our hospital. Proportions were compared with the chi(2) test. In 1997, 105 patients underwent open abdominal aortic aneurysm repair, with the majority of patients originating from the two regions in closest proximity to our hospital (I, 34%; II, 46%; III, 18%; IV, 2%). This contrasts with the 2003 EVAR group (n = 63), which had a higher proportion of patients referred from greater distances (I, 13%; II, 27%; III, 27%; IV, 33%) (p
PubMed ID
16374535 View in PubMed
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Identification of patient-derived outcomes after aortic aneurysm repair.

https://arctichealth.org/en/permalink/ahliterature105202
Source
J Vasc Surg. 2014 Jun;59(6):1528-34
Publication Type
Article
Date
Jun-2014
Author
Luc Dubois
Teresa V Novick
Adam H Power
Guy DeRose
Thomas L Forbes
Author Affiliation
Division of Vascular Surgery, London Health Sciences Centre and Western University, London, Ontario, Canada. Electronic address: luc.dubois@lhsc.on.ca.
Source
J Vasc Surg. 2014 Jun;59(6):1528-34
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - surgery
Blood Vessel Prosthesis Implantation - methods
Decision Making
Endovascular Procedures - methods
Female
Focus Groups
Follow-Up Studies
Humans
Incidence
Length of Stay - trends
Male
Middle Aged
Ontario - epidemiology
Patient Selection
Postoperative Complications - epidemiology
Prospective Studies
Risk Assessment - methods
Time Factors
Treatment Outcome
Abstract
Relatively few outcomes have been examined in randomized comparisons of endovascular and open aortic aneurysm repair, and no patient input was obtained in the selection of these outcomes. The aim of this study was to identify patient-derived, potentially novel outcomes that may be used to guide future clinical trials in aneurysm surgery.
Focus group interviews were conducted with patients who had undergone endovascular or open aortic aneurysm repair. The discussions were transcribed and the transcript was analyzed by two indexers using constant-comparison analysis and grounded theory to identify potentially novel, patient-derived outcomes. Other potential themes relating to the patients' experience and their decision-making were also sought.
Six focus groups were conducted (three with endovascular aneurysm repair patients and three with open aortic aneurysm repair patients), with a median of six participants, 2 to 12 months from surgery. Functional outcomes were most commonly mentioned and emphasized by patients. Recovery time and energy level were most frequently verbalized as important in the decision-making process between endovascular and open aneurysm repair. Other potential outcomes identified as important to patients included postoperative pain, time to walking normally, loss of appetite, extent and location of incisions, impact on cognition, being able to go home after surgery, and impact on caregivers. In addition to these outcomes, we identified three themes relating to the patient's experience: undervaluing or underappreciating the risk of death during surgery, differing informational needs and level of involvement in decision-making, and unrealistic patient expectations about the risks of and recovery after the procedure.
Functional outcomes emerged as most important during qualitative analysis of patients' experiences with aneurysm repair. Perceived differences in recovery time were identified as an important consideration for aneurysm patients in deciding between open and endovascular repair. More work needs to be done clarifying the concept of recovery and other related functional outcomes for the development of methods to assess and to evaluate these in prospective clinical trials.
PubMed ID
24447539 View in PubMed
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17 records – page 1 of 2.