Our Summary

This study examines whether the number of a certain type of vascular surgery (Endovascular Aneurysm Repair or EVAR) performed at a hospital affects the survival rates of patients undergoing this surgery. After reviewing 45 studies, the researchers found that the number of EVAR surgeries a hospital performed didn’t have an impact on patient survival rates. However, for a different kind of surgery for aneurysm repair (open procedures), hospitals that performed more of these surgeries had better survival rates. This suggests that EVAR surgeries can be safely carried out in smaller, less busy hospitals. However, more research is needed on surgeries using a specific type of EVAR (fenestrated EVAR), as there isn’t enough evidence to determine if hospital volume affects survival rates for this procedure.

FAQs

  1. Does the number of Endovascular Aneurysm Repair (EVAR) surgeries a hospital performs impact patient survival rates?
  2. Does performing more open procedures for aneurysm repair in a hospital lead to better survival rates?
  3. Is there enough evidence to determine if the volume of fenestrated EVAR surgeries performed at a hospital affects patient survival rates?

Doctor’s Tip

One helpful tip a doctor might tell a patient about aortic aneurysm repair is to discuss with their healthcare provider about the type of procedure being recommended (such as EVAR or open surgery) and to inquire about the hospital’s experience and volume of performing that specific procedure. This information can help patients make informed decisions about their treatment and potentially improve their outcomes.

Suitable For

Patients who are typically recommended aortic aneurysm repair include those with:

  • Abdominal aortic aneurysms (AAA) that are large in size (greater than 5.5 cm) or rapidly growing
  • Thoracic aortic aneurysms (TAA) that are at risk of rupture or causing symptoms
  • Aortic aneurysms that are causing symptoms such as back or abdominal pain, shortness of breath, or difficulty swallowing
  • Aortic aneurysms in patients with connective tissue disorders such as Marfan syndrome or Ehlers-Danlos syndrome
  • Patients with a family history of aortic aneurysms or aortic dissections

Ultimately, the decision to recommend aortic aneurysm repair will depend on the individual patient’s overall health, the size and location of the aneurysm, and the potential risks and benefits of surgery versus monitoring.

Timeline

Before aortic aneurysm repair:

  • Patient may experience symptoms such as chest or back pain, shortness of breath, and difficulty swallowing
  • Patient undergoes diagnostic tests such as imaging scans to confirm the presence of an aortic aneurysm
  • Patient consults with a vascular surgeon to discuss treatment options and risks
  • Surgical team plans the procedure and discusses post-operative care with the patient

After aortic aneurysm repair:

  • Patient undergoes the aortic aneurysm repair surgery, which can be done through open surgery or endovascular surgery
  • Patient is monitored in the hospital for complications such as bleeding or infection
  • Patient is discharged from the hospital and continues to follow up with their vascular surgeon for post-operative care and monitoring
  • Patient may need to make lifestyle changes such as quitting smoking and maintaining a healthy diet to prevent future aneurysms or complications

What to Ask Your Doctor

  1. What are the different treatment options for aortic aneurysm repair?
  2. What are the risks and benefits of undergoing endovascular aneurysm repair (EVAR) compared to open surgery?
  3. How many EVAR procedures does the hospital perform each year?
  4. What is the hospital’s success rate for EVAR surgeries?
  5. Are there any specific criteria or qualifications that make me a good candidate for EVAR surgery?
  6. How experienced is the surgical team in performing EVAR procedures?
  7. What is the recovery process like after EVAR surgery?
  8. What are the potential complications or side effects associated with EVAR surgery?
  9. Are there any lifestyle changes or medications I will need to take after undergoing EVAR surgery?
  10. Are there any ongoing clinical trials or research studies related to aortic aneurysm repair that I should be aware of?

Reference

Authors: Saricilar EC, Iliopoulos J, Ahmad M. Journal: J Vasc Surg. 2021 Jul;74(1):287-295. doi: 10.1016/j.jvs.2020.12.104. Epub 2021 Feb 4. PMID: 33548427