Feature | July 15, 2014

Minimally Invasive Aortic Stent Graft Repairs Prove Safer Than Surgery

July 15 2014 — Researchers at the University of California, San Diego School of Medicine have documented the safety benefits of aortic stent grafts inserted during minimally invasive surgery to repair abdominal aortic aneurysms in a study published July 9 in JAMA Surgery.

The study shows that patients who received the minimally invasive aortic repair procedure had a 42 percent reduction in preventable post-operative complications and a 72 percent reduction in mortality, compared with those who had undergone open repair surgery.

The safety of the endovascular "inside blood vessel" procedure also appears to be improving over time, as researchers documented a 37 percent reduction in the likelihood of an avoidable complication between 2003 and 2010.

The statistics are based on an analysis of 70,946 cases of abdominal aortic aneurysm repair performed over the seven-year period, culled from a nationwide hospital database maintained by the Healthcare Cost and Utilization Project.

"All this is good news for patients because endovascular repair has become the most common treatment for abdominal aortic aneurysms," said senior author John Lane, M.D., director of endovascular surgery at UC San Diego Health System and associate professor at the UC San Diego School of Medicine. The lead author is John Rose, M.D., a resident physician at UC San Diego School of Medicine.

Endovascular aortic aneurysm repair involves accessing the damaged aorta by first puncturing a blood vessel in the groin, often without making an incision, and then inserting a metallic stent that is guided using X-ray to the target area where it is then expanded. By contrast, in open repair surgery, surgeons make a large incision in the abdomen and manually sew a reinforcement graft into place.

"We have known that minimally invasive procedures are safer for patients," said Lane, who is also chief of endovascular surgery at Veterans Affairs San Diego Healthcare System. "It has been shown in randomized clinical trials and noted anecdotally. This is, however, the first time that we have been able to show that endovascular aneurysm repair is safer in terms of preventing complications in the hospital, as measured by patient safety indicators."

The value of the study, he said, is that it rigorously documents the benefits within the context of more than a dozen formally tracked patient safety indicators (PSIs), included in nationwide hospital care databases to help monitor and prevent avoidable complications during hospitalizations.

These PSIs include wound infection, blood infection (sepsis), hip fracture, accidental puncture or laceration and transfusion reaction and mortality among patients diagnosed as low-risk.

The findings represent a repeatable, statically defensible method for evaluating the comparative safeties of different surgical treatment options, particularly new methods.

"Medical errors and patient safety are an ongoing concern with any new surgical innovation," said David C. Chang, Ph.D., MPH, MBA, director of outcomes research at UC San Diego School of Medicine and a co-author. "This study shows the value in monitoring the safety of innovations. Patients need to keep this type of information in mind when considering different treatment options."

For more information: www.health.ucsd.edu

Related Content

coronary CT angiography, CCTA, alcohol consumption, CAD, coronary artery disease, RSNA 2016
News | CT Angiography (CTA)| November 29, 2016
Researchers using coronary computed tomography angiography (CCTA) found no association between light to moderate...
News | Cath Lab| November 21, 2016
November 21, 2016 – A single-center study sponsored by the National Institutes of Health (NHLBI) failed to show an ea
InspireMD, CGuard embolic protection system, EPS, clinical data, internal carotid artery stenosis, ICA
News | Stents Carotid| November 18, 2016
November 18, 2016 — InspireMD Inc.
Boston Scientific, HeartLogic Heart Failure Diagnostic Service, MultiSENSE trial data, AHA Scientific Sessions 2016
News | Heart Failure| November 18, 2016
Boston Scientific recently announced results from the first clinical trial evaluating the performance of the HeartLogic...
cardiac rehabilitation, depression, death risk, heart surgery, Intermountain Medical Center Heart Institute, AHA Scientific Sessions 2016
News | Cardiac Rehabilitation| November 15, 2016
Depression has been known to be associated with poor cardiovascular outcomes. But if patients who are depressed attend...
atrial fibrillation, warfarin, dementia, Intermountain Medical Center Heart Institute, American Heart Association, AHA Scientific Sessions 2016
News | Atrial Fibrillation| November 15, 2016
Atrial fibrillation patients who use warfarin to lower risk of stroke are at higher risk of developing dementia than...
PET/CT, calcium blockages, heart attack risk, Intermountain study, American Heart Association, AHA Scientific Sessions 2016
News | PET-CT| November 15, 2016
Many people who experience chest pain but don’t have a heart attack breathe a big sigh of relief when a stress test...
bivalirudin, heparin, blood clot prevention medication, PCI, percutaneous coronary intervention, Intermountain study, AHA Scientific Sessions
News | Antiplatelet and Anticoagulation Therapies| November 14, 2016
Two differing blood clot prevention medications are just as safe and effective for patients undergoing percutaneous...
catheter ablations, atrial fibrillation, stroke risk, Intermountain Medical Center Heart Institute study, AHA Scientific Sessions, American Heart Association
News | Ablation Systems| November 14, 2016
Atrial fibrillation patients with a prior history of stroke who undergo catheter ablation lower their long-term risk of...
NeoChord, RECHORD Trial, first patient, DS1000 System, degenerative mitral regurgitation, DMR
News | Heart Valve Technology| November 10, 2016
NeoChord Inc. announced the first use of its DS1000 System in the United States as it enrolled the first patient in the...
Overlay Init