Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design

Objective. This retrospective cohort study is aimed at determining the safety and efficacy between Femoral Open-Cutdown access and Percutaneous access with Endovascular Aneurysm Repair (EVAR) by contrasting perioperative complication rates. We hypothesized that the percutaneous approach is a better...

Full description

Saved in:
Bibliographic Details
Main Authors: Peter DeVito, Ali Kimyaghalam, Sameh Shoukry, Robert DeVito, John Williams, Eashaa Kumar, Eugene Vitvitsky
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:International Journal of Vascular Medicine
Online Access:http://dx.doi.org/10.1155/2020/8823039
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832554576514908160
author Peter DeVito
Ali Kimyaghalam
Sameh Shoukry
Robert DeVito
John Williams
Eashaa Kumar
Eugene Vitvitsky
author_facet Peter DeVito
Ali Kimyaghalam
Sameh Shoukry
Robert DeVito
John Williams
Eashaa Kumar
Eugene Vitvitsky
author_sort Peter DeVito
collection DOAJ
description Objective. This retrospective cohort study is aimed at determining the safety and efficacy between Femoral Open-Cutdown access and Percutaneous access with Endovascular Aneurysm Repair (EVAR) by contrasting perioperative complication rates. We hypothesized that the percutaneous approach is a better alternative for aortic aneurysm patients as it is minimally invasive and has been demonstrated to decrease the length of hospital stay. Methods. We retrospectively reviewed data for patients undergoing EVAR between the years of 2005 and 2013. We then compared overall mortality, hematoma or seroma formation, graft infection, arterio-venous injury, distal embolization, limb loss, myocardial infarction or arrhythmia, and renal dysfunction. Results were demonstrated using a retrospective cohort study design to confirm the hematoma rate associated with EVAR open compared to percutaneous access. Results. Our series involves 73 patients who underwent percutaneous access for EVAR (n=49) or traditional open cutdown (n=24). Percutaneous access resulted in significantly less hematoma formation when compared to the traditional open cutdown (4% vs. 12.5%; p<0.059). Our analysis suggests decreased mortality rates associated with EVAR as compared to the Open-Cutdown method using Northside Medical Center’s Study and the OVER Veterans Affairs Cooperative Study (p=0.0053). Conclusion. Percutaneous access for EVAR is safe and effective when compared to Open-Cutdown access for aortic aneurysm patients. Percutaneous access was associated with decreased rates of in-hospital mortality, hematoma formation, graft infection, and respiratory failure.
format Article
id doaj-art-87927c6065eb4e6db57335a6cba27034
institution Kabale University
issn 2090-2824
2090-2832
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series International Journal of Vascular Medicine
spelling doaj-art-87927c6065eb4e6db57335a6cba270342025-02-03T05:51:15ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322020-01-01202010.1155/2020/88230398823039Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study DesignPeter DeVito0Ali Kimyaghalam1Sameh Shoukry2Robert DeVito3John Williams4Eashaa Kumar5Eugene Vitvitsky6University of Arizona, Tucson, AZ, USADepartment of Vascular Surgery, Trumbull Regional Medical Center, Warren, OH, USAAmerican University of Antigua College of Medicine, Coolidge, Antigua, USANortheast Ohio Medical University, Rootstown, OH, USADepartment of Vascular Surgery, Trumbull Regional Medical Center, Warren, OH, USADepartment of Vascular Surgery, Trumbull Regional Medical Center, Warren, OH, USADepartment of Vascular Surgery, Trumbull Regional Medical Center, Warren, OH, USAObjective. This retrospective cohort study is aimed at determining the safety and efficacy between Femoral Open-Cutdown access and Percutaneous access with Endovascular Aneurysm Repair (EVAR) by contrasting perioperative complication rates. We hypothesized that the percutaneous approach is a better alternative for aortic aneurysm patients as it is minimally invasive and has been demonstrated to decrease the length of hospital stay. Methods. We retrospectively reviewed data for patients undergoing EVAR between the years of 2005 and 2013. We then compared overall mortality, hematoma or seroma formation, graft infection, arterio-venous injury, distal embolization, limb loss, myocardial infarction or arrhythmia, and renal dysfunction. Results were demonstrated using a retrospective cohort study design to confirm the hematoma rate associated with EVAR open compared to percutaneous access. Results. Our series involves 73 patients who underwent percutaneous access for EVAR (n=49) or traditional open cutdown (n=24). Percutaneous access resulted in significantly less hematoma formation when compared to the traditional open cutdown (4% vs. 12.5%; p<0.059). Our analysis suggests decreased mortality rates associated with EVAR as compared to the Open-Cutdown method using Northside Medical Center’s Study and the OVER Veterans Affairs Cooperative Study (p=0.0053). Conclusion. Percutaneous access for EVAR is safe and effective when compared to Open-Cutdown access for aortic aneurysm patients. Percutaneous access was associated with decreased rates of in-hospital mortality, hematoma formation, graft infection, and respiratory failure.http://dx.doi.org/10.1155/2020/8823039
spellingShingle Peter DeVito
Ali Kimyaghalam
Sameh Shoukry
Robert DeVito
John Williams
Eashaa Kumar
Eugene Vitvitsky
Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design
International Journal of Vascular Medicine
title Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design
title_full Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design
title_fullStr Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design
title_full_unstemmed Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design
title_short Comparing and Correlating Outcomes between Open and Percutaneous Access in Endovascular Aneurysm Repair in Aortic Aneurysms Using a Retrospective Cohort Study Design
title_sort comparing and correlating outcomes between open and percutaneous access in endovascular aneurysm repair in aortic aneurysms using a retrospective cohort study design
url http://dx.doi.org/10.1155/2020/8823039
work_keys_str_mv AT peterdevito comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign
AT alikimyaghalam comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign
AT samehshoukry comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign
AT robertdevito comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign
AT johnwilliams comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign
AT eashaakumar comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign
AT eugenevitvitsky comparingandcorrelatingoutcomesbetweenopenandpercutaneousaccessinendovascularaneurysmrepairinaorticaneurysmsusingaretrospectivecohortstudydesign