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dc.contributor.advisorMattsson, Erneynb_NO
dc.contributor.authorUnsgård, Runa G.nb_NO
dc.date.accessioned2014-12-19T14:17:33Z
dc.date.available2014-12-19T14:17:33Z
dc.date.created2014-05-08nb_NO
dc.date.issued2013nb_NO
dc.identifier716242nb_NO
dc.identifier.urihttp://hdl.handle.net/11250/263265
dc.description.abstractIntroduction: Over the past decades EVAR has become a widespread method of treatment for abdominal aortic aneurysm (AAA). EVAR has been connected with enthusiasm. There are however indications that EVAR should not be used outside oven indications or instructions. When EVAR has been used with low compliance with device instructions for use (IFU), a considerable percentage of the patients have faced AAA sac enlargement. At our hospital, the indications for EVAR treatment have been strictly applied. The aim of this study was to investigate the rate of sac enlargement after 5 years when the method has been used according to defined recommendations. Side objectives include complications, endoleaks, secondary procedures and mortality. Material and method: 147 patients were intended to be treated with EVAR during 2002-2007, according to the following indications; proximal aortic neck length 15mm, diameter 30mm, and straight configuration (cone shaped neck only with distal narrowing). One included patient had anatomy that did not meet the indications at our hospital; this patient had a neck length of 12mm and a suspected aorto-duodenal fistula. Independent radiologists have measured the sizes of the aneurysms with CT-scan before EVAR, within 6 months postoperatively and yearly thereafter. Growth of the aneurysm is defined as an increase in diameter of 5 mm or more. Results: In one elective patient the operation was not technically feasible because of the conditions in the iliac vessels. One acute operation was converted to open because of technical problems with the device. Excluding endoleaks, there were 15 patients (11,9%) with early complications, and 7 patients with (5,5%) late complications during the follow-up period (table III). 3 patients (2.4%) had systemic complications after EVAR. A total of 11 patients (8.7%) had implant related complications. Two patients had a rupture during follow-up (1.6%). 47 elective patients (35%) were registered with a total of 52 endoleaks during the follow-up period. 12.7% or 3.1 patients per 100 person years in this material had secondary procedures after 5 years. The causes of death are unknown. In the 30-day postoperative period, there was one death in the acute group and no deaths in the elective group. Over 5 years of follow-up there was no statistical difference in mortality rate of patients treated with elective and acute EVAR compared to the general population. Nine patients, 7.1%, (CI 3.3-10.8%) of the elective intended to treat patients had an increase in aneurysm diameter at five years. Of those 81 elective patients that reached a 5-year control, 11.1% had an increase in neurysm diameter. In the whole material (elective + acute) intended to be treated with EVAR, 6.8 % had an increase in diameter at 5 years. Conclusions: This study indicates that adhering to proven indications for use of EVAR is important to have a low long-term risk for increased diameter, low mortality rate and low rate of secondary procedures in treated aortic aneurysmsnb_NO
dc.languageengnb_NO
dc.publisherNorges teknisk-naturvitenskapelige universitet, Det medisinske fakultetnb_NO
dc.title5-year results of endovascular treatment of abdominal aortic aneurysms used according to recommendationsnb_NO
dc.typeMaster thesisnb_NO
dc.source.pagenumber16nb_NO
dc.contributor.departmentNorges teknisk-naturvitenskapelige universitet, Det medisinske fakultetnb_NO


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