Impact of introducing endovascular aneurysm repair on treatment strategy for repair of abdominal aortic aneurysm - National hospital organization network study in Japan

Nobuhiro Handa, Masafumi Yamashita, Toshiki Takahashi, Toshihiro Onohara, Minoru Okamoto, Tsuyoshi Yamamoto, Yasushi Shimoe, Masahiro Okada, Yoshimitsu Ishibashi, Fuminori Kasashima, Jyunji Kishimoto, Akihiro Mizuno, Jyun Ichi Kei, Mikizou Nakai, Hitoshi Suhara, Masamitsu Endo, Takeshi Nishina, Tadashi Furuyama, Masakazu Kawasaki, Yoichirou Ueno

研究成果: ジャーナルへの寄稿記事

10 引用 (Scopus)

抄録

Background: The objective of the present study was to assess the hypothesis that the introduction of endovascular aneurysm repair (EVAR) into Japan has expanded the indication of abdominal aortic aneurysm (AAA) repair without increasing surgical mortality. Methods and Results: From 10 national hospitals, we registered a total of 2,154 consecutive patients (Open surgery [OS]: n=1,577, EVAR: n=577) over 8 years, divided into 4 time periods: Group I (2005-2006: n=522), Group II (2007-2008: n=475), Group III (2009-2010: n=551), Group IV, (2011-2012: n=606). Mean age increased over the 4 time periods (P<0.0001). The incidences of COPD, smoking history, history of abdominal surgery and concomitant malignancy significantly increased as well, while the numbers of patients with preoperative shock or high ASA status reduced over time. The proportion of EVAR in AAA repair increased from: 0% in Group I, 11.6% in Group II, 41.0% in Group III, to 48.8% in Group IV (P<0.0001). Early mortality was 0.8% in the EVAR and 3.4% in the OS (P<0.001) groups. Survival rates among the 4 groups free of all-cause death and aneurysm-related death at 1 year were 92.1-96.3% (P=0.1555) and 95.5-96.8% (P=0.9891), respectively. Multiple logistic regression analysis for surgical death failed to demonstrate survival advantage of EVAR over OS. Conclusions: Introduction of EVAR expanded the indication of AAA repair without increasing mortality, while high risk for anesthesia and emergency cases reduced over time.

元の言語英語
ページ(範囲)1104-1111
ページ数8
ジャーナルCirculation Journal
78
発行部数5
DOI
出版物ステータス出版済み - 1 1 2014

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Abdominal Aortic Aneurysm
Aneurysm
Japan
Organizations
Therapeutics
Mortality
Chronic Obstructive Pulmonary Disease
Cause of Death
Shock
Emergencies
Survival Rate
Anesthesia
Logistic Models
Smoking
History
Regression Analysis
Survival
Incidence
Neoplasms

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

これを引用

Impact of introducing endovascular aneurysm repair on treatment strategy for repair of abdominal aortic aneurysm - National hospital organization network study in Japan. / Handa, Nobuhiro; Yamashita, Masafumi; Takahashi, Toshiki; Onohara, Toshihiro; Okamoto, Minoru; Yamamoto, Tsuyoshi; Shimoe, Yasushi; Okada, Masahiro; Ishibashi, Yoshimitsu; Kasashima, Fuminori; Kishimoto, Jyunji; Mizuno, Akihiro; Kei, Jyun Ichi; Nakai, Mikizou; Suhara, Hitoshi; Endo, Masamitsu; Nishina, Takeshi; Furuyama, Tadashi; Kawasaki, Masakazu; Ueno, Yoichirou.

:: Circulation Journal, 巻 78, 番号 5, 01.01.2014, p. 1104-1111.

研究成果: ジャーナルへの寄稿記事

Handa, N, Yamashita, M, Takahashi, T, Onohara, T, Okamoto, M, Yamamoto, T, Shimoe, Y, Okada, M, Ishibashi, Y, Kasashima, F, Kishimoto, J, Mizuno, A, Kei, JI, Nakai, M, Suhara, H, Endo, M, Nishina, T, Furuyama, T, Kawasaki, M & Ueno, Y 2014, 'Impact of introducing endovascular aneurysm repair on treatment strategy for repair of abdominal aortic aneurysm - National hospital organization network study in Japan', Circulation Journal, 巻. 78, 番号 5, pp. 1104-1111. https://doi.org/10.1253/circj.CJ-14-0131
Handa, Nobuhiro ; Yamashita, Masafumi ; Takahashi, Toshiki ; Onohara, Toshihiro ; Okamoto, Minoru ; Yamamoto, Tsuyoshi ; Shimoe, Yasushi ; Okada, Masahiro ; Ishibashi, Yoshimitsu ; Kasashima, Fuminori ; Kishimoto, Jyunji ; Mizuno, Akihiro ; Kei, Jyun Ichi ; Nakai, Mikizou ; Suhara, Hitoshi ; Endo, Masamitsu ; Nishina, Takeshi ; Furuyama, Tadashi ; Kawasaki, Masakazu ; Ueno, Yoichirou. / Impact of introducing endovascular aneurysm repair on treatment strategy for repair of abdominal aortic aneurysm - National hospital organization network study in Japan. :: Circulation Journal. 2014 ; 巻 78, 番号 5. pp. 1104-1111.
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title = "Impact of introducing endovascular aneurysm repair on treatment strategy for repair of abdominal aortic aneurysm - National hospital organization network study in Japan",
abstract = "Background: The objective of the present study was to assess the hypothesis that the introduction of endovascular aneurysm repair (EVAR) into Japan has expanded the indication of abdominal aortic aneurysm (AAA) repair without increasing surgical mortality. Methods and Results: From 10 national hospitals, we registered a total of 2,154 consecutive patients (Open surgery [OS]: n=1,577, EVAR: n=577) over 8 years, divided into 4 time periods: Group I (2005-2006: n=522), Group II (2007-2008: n=475), Group III (2009-2010: n=551), Group IV, (2011-2012: n=606). Mean age increased over the 4 time periods (P<0.0001). The incidences of COPD, smoking history, history of abdominal surgery and concomitant malignancy significantly increased as well, while the numbers of patients with preoperative shock or high ASA status reduced over time. The proportion of EVAR in AAA repair increased from: 0{\%} in Group I, 11.6{\%} in Group II, 41.0{\%} in Group III, to 48.8{\%} in Group IV (P<0.0001). Early mortality was 0.8{\%} in the EVAR and 3.4{\%} in the OS (P<0.001) groups. Survival rates among the 4 groups free of all-cause death and aneurysm-related death at 1 year were 92.1-96.3{\%} (P=0.1555) and 95.5-96.8{\%} (P=0.9891), respectively. Multiple logistic regression analysis for surgical death failed to demonstrate survival advantage of EVAR over OS. Conclusions: Introduction of EVAR expanded the indication of AAA repair without increasing mortality, while high risk for anesthesia and emergency cases reduced over time.",
author = "Nobuhiro Handa and Masafumi Yamashita and Toshiki Takahashi and Toshihiro Onohara and Minoru Okamoto and Tsuyoshi Yamamoto and Yasushi Shimoe and Masahiro Okada and Yoshimitsu Ishibashi and Fuminori Kasashima and Jyunji Kishimoto and Akihiro Mizuno and Kei, {Jyun Ichi} and Mikizou Nakai and Hitoshi Suhara and Masamitsu Endo and Takeshi Nishina and Tadashi Furuyama and Masakazu Kawasaki and Yoichirou Ueno",
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T1 - Impact of introducing endovascular aneurysm repair on treatment strategy for repair of abdominal aortic aneurysm - National hospital organization network study in Japan

AU - Handa, Nobuhiro

AU - Yamashita, Masafumi

AU - Takahashi, Toshiki

AU - Onohara, Toshihiro

AU - Okamoto, Minoru

AU - Yamamoto, Tsuyoshi

AU - Shimoe, Yasushi

AU - Okada, Masahiro

AU - Ishibashi, Yoshimitsu

AU - Kasashima, Fuminori

AU - Kishimoto, Jyunji

AU - Mizuno, Akihiro

AU - Kei, Jyun Ichi

AU - Nakai, Mikizou

AU - Suhara, Hitoshi

AU - Endo, Masamitsu

AU - Nishina, Takeshi

AU - Furuyama, Tadashi

AU - Kawasaki, Masakazu

AU - Ueno, Yoichirou

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: The objective of the present study was to assess the hypothesis that the introduction of endovascular aneurysm repair (EVAR) into Japan has expanded the indication of abdominal aortic aneurysm (AAA) repair without increasing surgical mortality. Methods and Results: From 10 national hospitals, we registered a total of 2,154 consecutive patients (Open surgery [OS]: n=1,577, EVAR: n=577) over 8 years, divided into 4 time periods: Group I (2005-2006: n=522), Group II (2007-2008: n=475), Group III (2009-2010: n=551), Group IV, (2011-2012: n=606). Mean age increased over the 4 time periods (P<0.0001). The incidences of COPD, smoking history, history of abdominal surgery and concomitant malignancy significantly increased as well, while the numbers of patients with preoperative shock or high ASA status reduced over time. The proportion of EVAR in AAA repair increased from: 0% in Group I, 11.6% in Group II, 41.0% in Group III, to 48.8% in Group IV (P<0.0001). Early mortality was 0.8% in the EVAR and 3.4% in the OS (P<0.001) groups. Survival rates among the 4 groups free of all-cause death and aneurysm-related death at 1 year were 92.1-96.3% (P=0.1555) and 95.5-96.8% (P=0.9891), respectively. Multiple logistic regression analysis for surgical death failed to demonstrate survival advantage of EVAR over OS. Conclusions: Introduction of EVAR expanded the indication of AAA repair without increasing mortality, while high risk for anesthesia and emergency cases reduced over time.

AB - Background: The objective of the present study was to assess the hypothesis that the introduction of endovascular aneurysm repair (EVAR) into Japan has expanded the indication of abdominal aortic aneurysm (AAA) repair without increasing surgical mortality. Methods and Results: From 10 national hospitals, we registered a total of 2,154 consecutive patients (Open surgery [OS]: n=1,577, EVAR: n=577) over 8 years, divided into 4 time periods: Group I (2005-2006: n=522), Group II (2007-2008: n=475), Group III (2009-2010: n=551), Group IV, (2011-2012: n=606). Mean age increased over the 4 time periods (P<0.0001). The incidences of COPD, smoking history, history of abdominal surgery and concomitant malignancy significantly increased as well, while the numbers of patients with preoperative shock or high ASA status reduced over time. The proportion of EVAR in AAA repair increased from: 0% in Group I, 11.6% in Group II, 41.0% in Group III, to 48.8% in Group IV (P<0.0001). Early mortality was 0.8% in the EVAR and 3.4% in the OS (P<0.001) groups. Survival rates among the 4 groups free of all-cause death and aneurysm-related death at 1 year were 92.1-96.3% (P=0.1555) and 95.5-96.8% (P=0.9891), respectively. Multiple logistic regression analysis for surgical death failed to demonstrate survival advantage of EVAR over OS. Conclusions: Introduction of EVAR expanded the indication of AAA repair without increasing mortality, while high risk for anesthesia and emergency cases reduced over time.

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