UAB Study Shows Secondary Intervention Rate After Stenting Aneurysm Less Than 10 Percent

A new study by University of Alabama at Birmingham (UAB) researchers has found that over their 10-year experience with stenting of abdominal aortic aneurysms, less than 10 percent of patients required a secondary intervention — and, of those who did, most procedures were minimally invasive.

July 2, 2010

BIRMINGHAM, Ala.  - A new study byUniversity of Alabama at Birmingham (UAB) researchers has found that over their 10-year experience with stenting of abdominal aortic aneurysms, less than 10 percent of patients required a secondary intervention - and, of those who did, most procedures were minimally invasive.

The study, which looked at stenting results over a longer period of time than current literature reports, was presented last month at the annual meeting of the Society for Vascular Surgery at the Vascular Annual Meeting. It prospectively evaluated the 1,000 endovascular repair of abdominal aortic aneurysms (EVAR) with aortic stent grafts that UAB vascular surgeons have done since 1999.

An abdominal aortic aneurysm occurs when the large blood vessel that supplies blood to the abdomen, pelvis and legs becomes abnormally large or balloons outward. In a traditional - or open - repair, a large cut is made in the abdomen and the abnormal vessel is then replaced with a graft made of man-made material. In EVAR, which is minimally invasive, a catheter is placed in the femoral artery and the stent is run through the artery to the site of the aneurysm. The stent is then placed in the spot of the aneurysm, giving blood a new pathway in which to travel, and not into the surrounding aneurysm sac. This immediately takes the pressure off the aneurysm, which eventually will shrink to near normal.

"In the early 2000s, there were some research reports suggesting EVAR was inappropriate because of the number of subsequent procedures necessary over the course of time to ensure the stent is performing correctly. Our research showed this was simply not the case," said UAB vascular surgery fellow and lead study author Brent Quinney, M.D.

Quinney said that of the 1,000 patients followed for 10 years, 9.4 percent required another intervention after the stent was placed. The study also showed that the majority of the secondary procedures were performed in a minimally-invasive fashion in the endovascular suite under local anesthesia. 

"We found that we were on par with the current literature and that we did very well in our one-, two- and five-year results," Quinney said. "We did see that there are some increased rates of re-intervention after five years, which is to be expected, and these results stress the importance of the lifelong surveillance that is required for EVAR patients."

Quinney added that what makes the findings of this study so strong is the length in which the patients were observed.

"Our study period was longer than those in the current literature," Quinney said. "From this we have concluded that EVAR is safe and effective for patients who prefer a minimally-invasive procedure with less hospitalization - when compared to open surgery and a seven- to 10-day stay - and any subsequent procedure can be performed under local anesthesia with minimal physiologic stress to the patient."

About the UAB Section of Vascular Surgery and Endovascular Therapy

The UAB Section of Vascular Surgery and Endovascular Therapy emphasizes the leading edge of treatment of vascular conditions, which includes new minimal surgical approaches to treatment of aneurysms, blood clotting and blocked arteries. UAB's vascular surgery and endovascular therapy staff specialize in the treatment of aneurysms, stroke, peripheral vascular disease, atherosclerosis, carotid artery diseases, renal artery diseases, mesenteric artery diseases and venous diseases.