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EVAR vs. OAR: One Community Hospital’s Experience. Westley Smith. Background. Abdominal Aortic Aneurysm (AAA). http://www.zenithstentgraft.com/patients/US/aaa/what/index.html. Methods. OAR 1.Large mid-line incision 2.Aneurysm dissected 3.Graft stitched into place

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EVAR vs. OAR: One Community Hospital’s Experience


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Presentation Transcript
background
Background

Abdominal Aortic Aneurysm (AAA)

http://www.zenithstentgraft.com/patients/US/aaa/what/index.html

methods
Methods

OAR

1.Large mid-line incision

2.Aneurysm dissected

3.Graft stitched into place

4.Aorta and Iliac Sutured

Pictures taken from: http://www.guidant.com/webapp/emarketing/compass/comp.jsp?lev1=proc&lev2=aaa

methods4
Methods

EVAR

1. Small Infrainguinal Incision

2. Catheter Insertion

3. Portable C-Arm (radiography)

4. Deployment

http://www.guidant.com/webapp/emarketing/compass/comp.jsp?lev1=proc&lev2=aaa

http://www.llnl.gov/str/pdfs/05_00.3.pdf

http://www.ziehm.com/ZiehmVision.htm

Blood Flow

candidacy
Candidacy
  • Arteriosclerosis
  • Tortuosity
  • Infrarenal neck length/diameter
  • Iliac diameter
  • Patient preference
comorbidity and demographics
Comorbidity and Demographics

*

Note. *Between groups Pulmonary Disease measured significantly different X2= 13.688, p= .001

conclusions
Conclusions

Candidates for EVAR have tolerated a less invasive procedure without sacrificing postoperative results. The current study is indicative support for the surgeon’s continuation with EVAR – given amendable anatomical characteristics, and pending the long-term results of larger trial facilities.

references
References

Chuter TA, Reilly LM, Faruqui RM, Kerlan RB, Sawhney R, Canto CJ, et al. Endovascular

aneurysm repair in high risk patients. J Vas Surg; 31:122-33, 2000

Marek, J: Endoluminal graft repair of AAA by vascular surgeons at a nonclinical trial center. Presented at the Peripheral Vascular Surgery Society, 11th annual winter meeting, Snowmass, Colorado, January 11-14, 2002.

Moore WS: Two-year follow-up of patients with the EVT/Guidant (Ancure) bifurcated graft for endovascular AAA repair: Advantages and disadvantages of this device. Presented at the 27th Global Veith Meeting, New York City, New York, November 2000.

Abraham CZ, Chuter TA, Reilly LM, Okuhn SP, Pethan LK, Kerlan RB, Sawhney R, Buck DG, Gordon RL, Messina LM, et al: Abdominal aortic aneurysm repair with the Zenith stent graft: Short to midterm results. J Vas Surg; 36:217-225, 2002.

Zarins CK, White RA, Schwarten D, et al: AneuRx stent graft versus open surgical repair of abdominal aortic aneurysms: Multicenter prospective clinical trial. J Vas Surg; 29:292-308, 1999.

Hill BB, Yehuda WG, Lee WA, Arko FR, Cornelius O, Schubart PJ, Dalman RL, Harris JE, Fogarty TJ, Zarins CK, et al: Open versus endovascular AAA repair in patients who are morphological candidates for endovascular treatment. J Endovasc Ther; 9:255-261, 2002.

slide12

Special Thanks to:

The Biology Department

&

Dr. Daniel McGraw and his Office Staff