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Multicentre Post-EVAR Surveillance Evaluation Study (EVAR-SCREEN).

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Summary
This summary is machine-generated.

Patient compliance with surveillance imaging after endovascular aneurysm repair (EVAR) in the UK was only 66%, impacting long-term survival. Adherence to post-EVAR surveillance is crucial for sustained patient benefit.

Keywords:
Abdominal aortic aneurysmEndovascular proceduresEpidemiologyStents

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Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Public Health

Background:

  • Post-operative surveillance imaging is mandatory following endovascular aneurysm repair (EVAR).
  • Patient loss to follow-up and non-compliance with surveillance protocols are significant challenges.
  • The impact of non-compliance on outcomes after EVAR is not well understood.

Purpose of the Study:

  • To assess compliance rates with post-operative surveillance in the UK after EVAR.
  • To investigate the influence of surveillance compliance on endograft re-interventions and patient survival.

Main Methods:

  • Analysis of EVAR procedures performed between 2007-2010 in 10 UK centers, with follow-up until 2014.
  • Non-compliance defined as a 18-month period without surveillance imaging.
  • Survival analysis comparing compliant and non-compliant patient groups.

Main Results:

  • Overall surveillance compliance was 66%, with significant variation (9%-88%) between centers.
  • Age and distance from hospital were predictors of non-compliance.
  • Non-compliant patients showed lower mortality in the first three years, while compliant patients had better survival at 4-5 years post-EVAR. Re-intervention rates did not differ significantly.

Conclusions:

  • A significant proportion of patients exhibit non-compliance with EVAR surveillance in the UK, with wide inter-center variability.
  • Survival benefits observed after three years appear linked to surveillance compliance.
  • These findings have implications for the future delivery and management of EVAR care.