Key result
This is a study protocol for a retrospective cohort study evaluating the impact of yearly imaging surveillance on intervention-free survival and aneurysm-related mortality after EVAR.
Why the study?
Controversy exists over whether all EVAR patients need intense surveillance, with guidelines suggesting that low-risk patients may need only limited imaging follow-up.
Does yearly imaging surveillance improve intervention-free survival and overall survival compared to limited follow-up in patients after endovascular aortic aneurysm repair?
Cohort (n=1,997)
Yes
Does yearly imaging surveillance improve intervention-free survival and overall survival compared to limited follow-up in patients after endovascular aortic aneurysm repair?
This study protocol outlines a national multicenter retrospective cohort study to evaluate whether yearly imaging surveillance after EVAR is necessary for all patients or if limited follow-up is safe for low-risk patients.
Yearly post-EVAR surveillance benefit remains unproven; this protocol leaves open whether limited follow-up suffices in low-risk patients.
INTRODUCTION: Strict imaging surveillance protocols to detect complications following endovascular aneurysm repair (EVAR) are common practice. However, controversy exists as to whether all EVAR patients need intense surveillance. The 2019 European Society for Vascular Surgery guidelines for management of abdominal aortic aneurysm (AAA) suggest that patients may be considered for limited follow-up with imaging if classified as 'low risk' for complications based on their initial postoperative imaging. The current study aims to investigate the intervention-free survival and overall survival stratified for patients with and without yearly imaging surveillance. METHODS AND ANALYSIS: The Observing a Decade of Yearly Standardised Surveillance in EVAR patients with Ultrasound or CT Scan study comprises a national multicentre retrospective cohort study in 17 medical centres. Consecutive patients with an asymptomatic or symptomatic infrarenal AAA who underwent EVAR between January 2007 and January 2012 will be included in this study with follow-up until December 2018. Clinical variables and all follow-up information will be retrieved in extensive data collection from the patient's medical records. In addition, an e-survey was sent to vascular surgeons at the 17 participating centres to gauge their opinions regarding the possibility of safely reducing the frequency of imaging surveillance. Primary endpoints are intervention after EVAR and aneurysm-related mortality. The initial estimated sample size is 1997 patients. ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Review Committee of the Amsterdam UMC, location Academic Medical Centre, Amsterdam, the Netherlands. Study findings will be disseminated via presentations at conferences and publications in peer-reviewed journal. TRIAL REGISTRATION NUMBER: The Netherlands Trial Registry, NL6953 (old: NTR28773).
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Geraedts et al. (2020) conducted a cohort in Abdominal aortic aneurysm (AAA) post-EVAR (n=1,997). Yearly imaging surveillance vs. No yearly imaging surveillance was evaluated on Intervention after EVAR and aneurysm-related mortality. This is a study protocol for a retrospective cohort study evaluating the impact of yearly imaging surveillance on intervention-free survival and aneurysm-related mortality after EVAR.
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