Applicability of ASA classification system in elective endovascular aneurysm repair

Objectives: This study aims to examine the American Society of Anesthesiologists (ASA) classification of Physical Status as a preoperative risk prediction method for early mortality and morbidity in patients undergoing elective endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA). Patients and methods: A total of 134 consecutive patients (124 males, 10 females; mean age 69.6±6.9 years; range, 52 to 85 years) with an infrarenal AAA who underwent EVAR between January 2012 and January 2018 were retrospectively analyzed. The patients were divided into two groups as Group 1 (low risk; ASA I-II; n=63) and Group 2 (high risk; ASA III-IV; n=71). Early and postoperative one-year mortality and morbidity were evaluated. Results: The overall early mortality rate was 1.4%. None of the patients were converted to open surgery and overall technical success was 100%. Unibody grafts were performed in 33% patients in Group 1 and 59.2% patients in Group 2 (p=0.003). The length of intensive care unit and hospital stay was longer in Group 2, although it did not reach statistical significance. A total of 64% of local/locoregional anesthesia was performed in Group 2 high-risk patients. Conclusion: Regardless of the ASA risk group, EVAR can be performed successfully. The ASA classification may be useful for decision of treatment modality. Patients unfit for open surgery can be managed safely by EVAR [Turk J Vasc Surg 2019; 28(2.000): 101-6]