Results from the monitoring use programme for endovascular repair of abdominal aortic aneurysms in Spain.
OBJECTIVE
The aim of this study was to present the results from the Monitoring Use Programme (MUP) for endovascular repair (ER) of abdominal aortic aneurysms (AAA) using stent grafts in Spain, carried out to determine the procedure's effectiveness and safety.


METHODS
This was a follow-up study carried out through a multicentric-case registry between 2001-2003. Variables were grouped into: 1) general information, 2) postoperative period and 3) follow-up period.


RESULTS
The study enrolled 740 cases (97% males), from 32 hospitals. Mean age of patients was 72.7+/-7.3 years. Mean AAA diameter was 59.5+/-13.7 mm. Forty-seven percent of patients required additional intervention procedures; 19% patients presented intervention complications (53% were endoleaks). The endovascular intervention could not be completed in 6 patients, and in 2 patients the operation was changed to conventional surgery; 24% patients suffered, mostly minor, postoperative complications. Between 4-24 months, follow-up was normal in 81-85% cases with the most common complication being endoleaks (7%). After 24 months, and especially after 37, reinterventions and complications, in particular angulation and stent migration, increased, mainly associated to the Vanguard device. After 37 months, an increase in AAA size was observed. Among patients with preoperative AAA<50 mm, there was a greater proportion of individuals requiring additional procedures (60% vs 41%, P<0.01), suffering postoperative complications (26% vs 24%), and presenting more leaks (71% vs 52%), than among patients with AAA >or= 50 mm.


CONCLUSIONS
ER of AAA shows favourable results in the short/medium term with regards to procedure safety and effectiveness. The appearance of some complications and increase in AAA size 2-3 years after ER raises the need for caution. Care should be taken when considering ER of small AAA.
Polo-De Santos
M
M
Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, Spain. mpolo@isciii.es
Luengo-Matos
S
S
Muñoz-Navarro
B
B
Saz-Parkinson
Z
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018579:Patient Selection; D016730:Program Development; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome