EVAR vs Open Repair M OVER 3 0

EVAR vs. Open Repair Τυχαιοποιημένες Mελέτες OVER 3. 0% 0. 5% Γ. Σφυρόερας 19ο HSVS Congress 2020

EVAR 1: Κακοήθειες Αυξημένο ποσοστό κακοήθειας σε EVAR Health Technology Assessment Volume: 22, Issue: 5, 2018 Γ. Σφυρόερας 19ο HSVS Congress 2020

Length of life following procedures for AAA Aneurysm related survival EVAR Total survival OPEN EVAR Chris Hammond, CACVS 2019 OPEN

Very Long-term Follow-up in the EVAR-2 Trial Aneurysm related survival EVAR NO REPAIR Overall Survival Sweeting et al. Annals of Surgery 2017

EVAR και καρδιαγγειακά αποτελέσματα • Μια μη-στατιστικά σημαντική τάση για καρδιαγγειακούς θανάτους ήταν φανερή στις μελέτες EVAR στο ενδαγγειακό σκέλος κατά τη διάρκεια της 2ετούς παρακολούθησης. • Η καρδιαγγειακή θνητότητα αποδόθηκε κυρίως στις επιπλέον απαιτηθείσες επεμβάσεις. 1. 2. Brown LC, et al. EVAR trial participants. Does EVAR alter the rate of cardiovascular events in patients with AAA considered unfit for open repair? Results from the randomized EVAR trial 2. EJVES 2010 Brown LC, et al. EVAR trial participants. Incidence of cardiovascular events and death after open or endovascular repair of abdominal aortic aneurysm in the randomized EVAR trial 1. Br J Surg. 2011

Short-term vs. long-term MI following EVAR and Open AAA Repair b Stather et. al British Journal of Surgery 2013; 100: 863– 872

Arterial stiffness, circulating vascular calcification inhibitors and inflammatory mediators in pts with AAA • PWV and hs. CRP, WBC, IL-6, Osteoprotegerin were significantly upregulated in pts with AAA. • Independent association of PWV with mean blood pressure, OPG and AAA diameter Kadoglou NP, Liapis CD et al. Arterial stiffness and novel biomarkers in patients with abdominal aortic aneurysms. Regul Pept. 2012

Differential effects of stent-graft fabrics on arterial stiffness in patients undergoing EVAR N=118 pts Values of PWV and novel biomarkers at baseline and after 12 months PWV, OPG and IL-8 increase was more pronounced in Polyester Woven group compared to PTFE group (p=0. 033, p=0. 048, p<0. 001 respectively) Kadoglou NP, Moulakakis KG, Liapis CD. Differential effects of stent-graft fabrics on arterial stiffness in patients undergoing endovascular aneurysm repair. J Endovasc Ther. 2014

Non‑invasive Determination of Aortic Mechanical Properties and Their Effects on Left Ventricular Function Following EVAR Το σκληρό ενδομόσχευμα επηρεάζει τον χρονισμό των ανακλώμενων κυμάτων και συνεπώς έχει αρνητικές επιπτώσεις στη λειτουργία της αριστερής κοιλίας Pre-EVAR Gregory A. et. al Journal of Medical and Biological Engineering 2018 Post-EVAR

7 -day cardiac effects of EVAR Takeda Y. et al Circ J 2014; 78: 322 -328

Στατιστική και οικονομικά της υγείας QALYs Ποιότητα ζωής PROMs QALY Διάρκεια ζωής Μακροχρόνια αποτελέσματα Quality-adjusted life year: One QALY = 1 year of perfect health PROMs: Patient‐reported outcome measures