Borgen Lars, Aasekjær Kjartan, Skoe Øyvind Werpen
Department of Radiology, Drammen Hospital, Vestre Viken Health Trust, Dronning gaten 28, 3004 Drammen, Norway.
Department of Surgery, Drammen Hospital, Vestre Viken Health Trust, Dronning gaten 28, 3004 Drammen, Norway.
Eur J Radiol Open. 2023 Sep 4;11:100522. doi: 10.1016/j.ejro.2023.100522. eCollection 2023 Dec.
At the introduction of endovascular aortic repair (EVAR) in 2013 in our non-university hospital, we established a quality registry to monitor our EVAR activity.
To observe if we over time were able to exploit EVAR as a minimally invasive method in an elective as well as emergency setting, and to monitor our treatment quality in terms of complications, secondary interventions and mortality.
From November 2013 to March 2022, we treated 207 patients with EVAR, including six patients with rupture. Follow-up regimen was partly based on contrast-enhanced computer tomography, and partly on contrast-enhanced ultrasound in combination with plain radiography.
During the observation period, the method of anesthesia changed from general, via spinal, to local anesthesia. The groin access changed from surgical cut down to percutaneous and the median length of postoperative stay decreased from 3 days to 1 day. EVAR on ruptured aneurysm was done for the first time in 2019. Endoleak was detected in 85 patients (42%) and 37 patients (18%) had one or more secondary interventions, of which 85% were endovascular. Estimated five-year survival was 72% in patients below 80 years of age and 45% in patients 80 years or older.
Nine years of experience enabled us to exploit EVAR's advantages as a minimally invasive method in an elective as well as emergency setting. Complications, secondary interventions and survival rates in our low volume non-university hospital matches results from larger vascular centers.
2013年我们这家非大学附属医院引入血管内主动脉修复术（EVAR）时，建立了一个质量登记系统来监测我们的EVAR手术情况。
观察随着时间推移，我们是否能够在择期和急诊情况下将EVAR作为一种微创方法加以应用，并从并发症、二次干预和死亡率方面监测我们的治疗质量。
2013年11月至2022年3月，我们对207例患者实施了EVAR手术，其中包括6例破裂患者。随访方案部分基于增强计算机断层扫描，部分基于增强超声联合X线平片。
在观察期内，麻醉方法从全身麻醉，经脊髓麻醉，转变为局部麻醉。腹股沟入路从手术切开改为经皮穿刺，术后中位住院时间从3天降至1天。2019年首次对破裂动脉瘤实施了EVAR手术。85例患者（42%）检测到内漏，37例患者（18%）进行了一次或多次二次干预，其中85%为血管内干预。80岁以下患者的估计五年生存率为72%，80岁及以上患者为45%。
九年的经验使我们能够在择期和急诊情况下利用EVAR作为微创方法的优势。我们这家规模较小的非大学附属医院的并发症、二次干预和生存率与大型血管中心的数据相当。
