title: Do we need long-term follow-up after EVAR and TEVAR or can we simplify surveillance protocols?
abstract: Endovascular repair is an increasingly preferred treatment modality for aortic pathology. Concerns regarding durability and postimplant complications have let to recommendations for rigorous surveillance regimens which are not entirely data-driven. Besides the costs of an excessive imaging follow-up protocol, deleterious effects may arise from repeated contrast administration and radiation exposure. Due to improvements in selection, planning and execution, coupled with technical improvements in devices, reported complications following endovascular repair have gradually decreased since the pivotal reports. Although late failure may be multifactorial and therefore not totally preventable with any surveillance regimen, patients may be stratified according to the expected risk (balanced by the potential benefit gained with surveillance) and be offered an individualized surveillance program. In this review, we aimed to describe current strategies for surveillance, modern outcomes after abdominal and thoracic endovascular repair, and proposed risk-adapted strategies for postoperative surveillance.
authors.affiliation: Department of Vascular Surgery Erasmus University Medical Centre Rotterdam, The Netherlands - n.gomesoliveira@erasmusmc.nl.
authors.forename: N
authors.initials: N
authors.lastname: Oliveira
authors.forename: F
authors.initials: F
authors.lastname: Bastos Gonçalves
authors.forename: S
authors.initials: S
authors.lastname: Ten Raa
authors.forename: E
authors.initials: E
authors.lastname: Rouwet
authors.forename: J M
authors.initials: JM
authors.lastname: Hendriks
authors.forename: I
authors.initials: I
authors.lastname: Cássio
authors.forename: L
authors.initials: L
authors.lastname: Mota Capitão
authors.forename: H
authors.initials: H
authors.lastname: Verhagen
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D018810:Magnetic Resonance Angiography; D011183:Postoperative Complications / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome