Outpatient Endovascular Aortic Aneurysm Repair: Experience in 100 Consecutive Patients

Felice Pecoraro, Christian Alexander Schmidt, Frank Junior Veith, Mario Louis Lachat, Dominique Bettex, Gilbert Puippe, Michael Glenck, Carole Guillet, Zoran Rancic, Jacques Bleyn, Dieter Mayer

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Abstract

Objectives: To present the safety, feasibility, costs, and patient satisfaction ofoutpatient endovascular aneurysm repair (EVAR).Background: Our experience in more than 1000 patients indicated that intechnically uncomplicated EVAR procedures, the only need for hospitalizationwas for access vessel complications (bleeding or occlusion) requiringsecondary procedures. These complications could always be identified withinthe first 3 hours after EVAR.Methods: Two-center retrospective analysis of prospectively gathered dataon 100 consecutive elective outpatient EVAR cases (Outpt EVAR). Inclusioncriteria forOutptEVARwere as follows: asymptomatic clinical state, informedconsent, travel time to the hospital if readmission was required of less than60 minutes, adult observer assistance for the first 24 hours, and a technicallyuncomplicated EVAR procedure. EVAR was mostly performed under localanesthesia and with percutaneous access. Patients were discharged home after4 to 6 hours of observation and checked the next morning and on the fifthpostoperative day in the outpatient clinic.Results: From 104 patients selected, 4 (3.8%) preferred primary hospitalizationand were excluded from further analysis. Four patients (4%) with accessvessel complications required additional procedures and had to be hospitalizedovernight. The 30-day readmission rate was 4% (4), all due to access vesselstenosis (2) or false aneurysm (2). There was no 30-day mortality. From the96 outpatients who completed Outpt EVAR, 93 (97%) would undergo OutptEVAR again and would recommend it to others. Cost comparison showed in42 matched contemporary patients treated with just a standard stent graft thatcosts were significantly lower in 21 Outpt EVAR patients than in 21 inpatientEVAR.Conclusions: Elective Outpt EVAR can be performed safely, provided certaincriteria are fulfilled and specific precautions are taken. In this series, OutptEVAR morbiditywasminimal, especially delirium common in elderly patientsrecovering from inpatient vascular surgery and nosocomial infections did notoccur. Finally, patient satisfaction was high and costs were less than withstandard inpatient EVAR
Lingua originaleEnglish
pagine (da-a)754-759
Numero di pagine6
RivistaAnnals of Surgery
Volume258
Stato di pubblicazionePublished - 2013

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All Science Journal Classification (ASJC) codes

  • Surgery

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Pecoraro, F., Schmidt, C. A., Veith, F. J., Lachat, M. L., Bettex, D., Puippe, G., Glenck, M., Guillet, C., Rancic, Z., Bleyn, J., & Mayer, D. (2013). Outpatient Endovascular Aortic Aneurysm Repair: Experience in 100 Consecutive Patients. Annals of Surgery, 258, 754-759.