title: Fast-track endovascular aortic repair: Interim report from the prospective LIFE registry.
abstract: OBJECTIVE
  To assess the feasibility, safety, and clinical utility of a fast-track endovascular aneurysm repair (EVAR) protocol.
  
  
  BACKGROUND
  Despite recent advances in EVAR technology and techniques, considerable opportunity exists to further improve EVAR efficiency and outcomes.
  
  
  METHODS
  Eligible patients underwent elective EVAR with the Ovation Prime stent graft. Successful completion of the fast-track protocol required bilateral percutaneous access, avoidance of general anesthesia and intensive care unit admission, and next-day discharge. Patients were followed through 1-month post-treatment.
  
  
  RESULTS
  Between October 2014 and September 2015, 129 patients were enrolled in the study. Vascular access, stent graft delivery, and stent graft deployment were successful in all patients. The fast-track EVAR protocol was successfully completed in 114 (88%) patients. Bilateral percutaneous access was achieved in 97% of cases. Comparing patients who completed fast-track requirements to those who failed at least one component, procedure time was 86 vs. 122 min, use of general anesthesia was 0% vs. 20%, need for intensive care unit stay was 0% vs. 13%, hospital stay was 1.1 vs. 2.1 days, and postoperative groin pain severity (0-10 scale) was 1.2 vs. 4.0. No type I or III endoleaks, serious device-related adverse events, AAA ruptures, surgical conversions, or AAA-related secondary procedures were reported. One (0.9%) patient in the fast-track group died from acute respiratory failure.
  
  
  CONCLUSIONS
  Initial results from the LIFE study are encouraging and suggest that a fast-track protocol is feasible, safe, and may improve efficiency of healthcare resource allocation in select patients undergoing EVAR. © 2016 Wiley Periodicals, Inc.
authors.affiliation: St. Luke's Episcopal Hospital, Houston, Texas.
authors.forename: Zvonimir
authors.initials: Z
authors.lastname: Krajcer
authors.affiliation: Arizona Heart Institute, Phoenix, Arizona.
authors.forename: Venkatesh G
authors.initials: VG
authors.lastname: Ramaiah
authors.affiliation: TriVascular, Inc, Santa Rosa, California.
authors.forename: Meredith
authors.initials: M
authors.lastname: Huetter
authors.affiliation: Miller Scientific Consulting, Inc, Asheville, North Carolina.
authors.forename: Larry E
authors.initials: LE
authors.lastname: Miller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D003695:Delivery of Health Care / Q000458:organization & administration; D017598:Efficiency, Organizational; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D010351:Patient Discharge; D015397:Program Evaluation; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality; D015607:Stents; D013997:Time Factors; D017748:Time Management; D016896:Treatment Outcome; D014481:United States
keywords: aortic disease; aortic repair; endovascular; endovascular intervention