title: Long-term follow-up of endovascular abdominal aortic aneurysm repair in a rural veteran patient population.
abstract: BACKGROUND
  The endovascular repair of abdominal aortic aneurysms (EVARs) requires follow-up to detect and treat late complications.
  
  
  METHODS
  Two hundred eleven patients underwent EVAR for infrarenal, nonruptured abdominal aortic aneurysms from 1999 to 2010 at the Raymond G. Murphy VA Medical Center, Albuquerque, NM. A retrospective review examined patient demographics, comorbidities, the distance the patient lived from the facility, early and late complications, and the device implanted. Statistical analysis included the chi-square test for independence, the Fisher exact test, and the 2-sample Mann-Whitney U test for means.
  
  
  RESULTS
  The mean time from the operation to the first complication was 21 months (standard deviation = 20 months) with a mean follow-up of 48 months (standard deviation = 36 months). The late complication rate was 22.8% (54 patients). Sixteen percent did not require any reinterventions, 57% were treated with percutaneous interventions, and 27% required an open surgical procedure. No single comorbidity, combination of comorbidities, distance the patient lived from the facility, or device implanted was predictive of complications.
  
  
  CONCLUSIONS
  EVAR follow-up is essential to detect complications. When complications occur, the majority occur well after the initial treatment, and most can be treated with minimally invasive percutaneous techniques.
authors.affiliation: Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
authors.forename: Erica L
authors.initials: EL
authors.lastname: McBride
authors.forename: Christina
authors.initials: C
authors.lastname: Paap
authors.forename: Cristina
authors.initials: C
authors.lastname: Murray-Krezan
authors.forename: James M
authors.initials: JM
authors.lastname: Goff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009516:New Mexico; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012423:Rural Health; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D058014:Veterans Health