Surgery, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The Netherlands.
Surgery, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The Netherlands
BMJ Open. 2020 Feb 18;10(2):e033584. doi: 10.1136/bmjopen-2019-033584.
Strict imaging surveillance protocols to detect complications following endovascular aneurysm repair (EVAR) are common practice. However, controversy exists as to whether all EVAR patients need intense surveillance. The 2019 European Society for Vascular Surgery guidelines for management of abdominal aortic aneurysm (AAA) suggest that patients may be considered for limited follow-up with imaging if classified as 'low risk' for complications based on their initial postoperative imaging. The current study aims to investigate the intervention-free survival and overall survival stratified for patients with and without yearly imaging surveillance.
The Observing a Decade of Yearly Standardised Surveillance in EVAR patients with Ultrasound or CT Scan study comprises a national multicentre retrospective cohort study in 17 medical centres. Consecutive patients with an asymptomatic or symptomatic infrarenal AAA who underwent EVAR between January 2007 and January 2012 will be included in this study with follow-up until December 2018. Clinical variables and all follow-up information will be retrieved in extensive data collection from the patient's medical records. In addition, an e-survey was sent to vascular surgeons at the 17 participating centres to gauge their opinions regarding the possibility of safely reducing the frequency of imaging surveillance. Primary endpoints are intervention after EVAR and aneurysm-related mortality. The initial estimated sample size is 1997 patients.
The study has been approved by the Medical Ethics Review Committee of the Amsterdam UMC, location Academic Medical Centre, Amsterdam, the Netherlands. Study findings will be disseminated via presentations at conferences and publications in peer-reviewed journal.
The Netherlands Trial Registry, NL6953 (old: NTR28773).
为了检测血管内动脉瘤修复术(EVAR)后的并发症,通常会采用严格的影像学监测方案。然而,对于所有 EVAR 患者是否都需要进行密集监测,目前仍存在争议。2019 年,欧洲血管外科学会发布了腹主动脉瘤(AAA)管理指南,建议根据患者术后初始影像学表现,将其分为并发症“低危”或“高危”,以决定是否采用限制随访影像学检查策略。本研究旨在探讨有无每年影像学监测的患者,其无干预生存率和总生存率的分层情况。
本研究是一项在 17 个医疗中心开展的全国多中心回顾性队列研究,研究对象为接受超声或 CT 扫描的无症状或有症状的肾下型 AAA 行 EVAR 治疗的患者。患者入选标准为:2007 年 1 月至 2012 年 1 月期间行 EVAR 治疗,且为连续患者。随访时间截止至 2018 年 12 月。研究将通过详细的病历资料收集,获取患者的临床变量和所有随访信息。此外,还向 17 个参与中心的血管外科医生发送电子调查问卷,以评估他们对安全减少影像学监测频率的看法。主要终点为 EVAR 后干预和与动脉瘤相关的死亡率。初步估计样本量为 1997 例患者。
该研究已获得荷兰阿姆斯特丹学术医学中心阿姆斯特丹 UMC 医学伦理审查委员会的批准。研究结果将通过会议报告和同行评议期刊发表进行传播。
荷兰临床试验注册中心,NL6953(旧注册号:NTR28773)。