Evidence map›Paper›PMID 39503070›Full record

ArticleThe British journal of surgery2024

Outcomes of elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysms in Sweden.

Harry H Y Yu, Giuseppe Asciutto, Nuno Dias, Anders Wanhainen, Angelos Karelis, Björn Sonesson, Kevin Mani

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In one paragraph

Article in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Harry H Y YuDepartment of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Giuseppe AsciuttoDepartment of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Nuno DiasVascular Centre, Department of Thoracic Surgery and Vascular Diseases, Skåne University Hospital, Malmö, Sweden.
Anders WanhainenDepartment of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
Angelos KarelisVascular Centre, Department of Thoracic Surgery and Vascular Diseases, Skåne University Hospital, Malmö, Sweden.
Björn SonessonVascular Centre, Department of Thoracic Surgery and Vascular Diseases, Skåne University Hospital, Malmö, Sweden.
Kevin ManiDepartment of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA juxtarenal abdominal aortic aneurysm is defined as a short (less than 4 mm) or no-neck aneurysm, which is often treated with open or complex endovascular repair. The evidence to support the best treatment strategy is scarce. The aim of this study was to assess the short- and mid-term outcomes of elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysms in Sweden.

methodsPatients who underwent elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysms between 2018 and 2021 were identified in the Swedish Vascular Registry. Demographics, practice patterns, and operative details were assessed. The primary outcome was 30-day mortality. Secondary outcomes included perioperative complications and mid-term survival.

resultsAmong 3777 aortic aneurysm repairs performed, 418 involved juxtarenal abdominal aortic aneurysms (open surgical repair 228 (54.5%), fenestrated endovascular aneurysm repair 176 (42.1%), chimney endovascular aneurysm repair 6 (1.4%), and branched endovascular aneurysm repair 8 (1.9%)). Some 25 centres performed juxtarenal abdominal aortic aneurysm repairs with open surgical repair and fenestrated endovascular aneurysm repair. The caseload varied from 2 to 54 repairs per centre. The mean aneurysm diameter was 61 mm. Endovascularly treated patients were older and had more pulmonary co-morbidities. The 30-day mortality rate was 2.2% (open surgical repair 2.6% and fenestrated endovascular aneurysm repair 1.7%; P = 0.397). Perioperative major complications occurred in 14.1% of patients (open surgical repair 19.3% and fenestrated endovascular aneurysm repair 7.4%; P < 0.001) and perioperative vascular complications occurred in 12.1% of patients (open surgical repair 8.8% and fenestrated endovascular aneurysm repair 11.9%; P = 0.190). The survival rate (estimated using Kaplan-Meier analysis) at 1 year and 3 years was 93.1% and 85.9% respectively for open surgical repair and 95.2% and 80.9% respectively for fenestrated endovascular aneurysm repair (P = 0.477).

conclusionThis nationwide study reveals considerable variations in volume and treatment strategy between Swedish centres performing juxtarenal abdominal aortic aneurysm repairs. Survival is comparable for open surgical repair and fenestrated endovascular aneurysm repair, although there are significant baseline demographic differences between patients selected for the two treatment modalities.

Indexed as

Aortic Aneurysm, AbdominalElective Surgical ProceduresEndovascular ProceduresPostoperative ComplicationsAgedAged, 80 and overBlood Vessel Prosthesis ImplantationEndovascular Aneurysm RepairFemaleHumansMaleMiddle AgedRegistriesRetrospective StudiesSwedenTreatment Outcome

Identifiers

PMID39503070
PMCPMC11538729

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.