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OBJECTIVES:
Patients who underwent EVAR have regular follow-up surveillance. At our institution and consistent with the current literature many patients are lost to follow-up despite emphasizing its importance. This study was designed to evaluate possible factors of non-compliance to endovascular aneurysm repair surveillance.
METHODS:
A retrospective review of patients who underwent elective and emergency EVAR for thoracic (TAA), abdominal aorta (AAA), and iliac artery aneurysm (IAA) at a single institution from November 2007 to March 2014 was performed. Patients with less than 12 months follow-up, open surgery, repair for dissection and transection were excluded. We evaluated the compliance to follow-up at 1, 6, and 12 months. Examined factors included patient demographics, size of aneurysm, distance to the clinic, risk factors for aneurysm, urgency of surgery and season.
RESULTS:
EVAR was performed in 205 patients (75% male and 25% female). Thirty-day mortality for elective cases was 1.1% (n = 2) and 16.1% (n = 5) for emergency cases (P = .001). Mortality at 12 months was 6.3% (n = 11) and 32.3% (n = 10), respectively (P = .0002). Highest compliance was seen at 1 month with 184 patients (93%) attending. A significant drop was observed at 6 (n = 102, 54%) and 12 months (n = 89, 48%). At 1 year, a greater proportion of the minority population was not compliant with follow-up recommendation. Cofounders for non-compliance were analyzed with a multivariate analysis and significance was seen in the widowed population (P = .008), travel distance of > 25 miles (P = .032), lack of history of hyperlipidemia (P = .022), and emergency repair of aneurysms (P = .022).
CONCLUSIONS:
Different factors may contribute to non-compliance to follow-up surveillance. Our study demonstrated travel distance, marital status, history of hyperlipidemia and urgency of surgery to play a role in compliance to follow-up surveillance and merits further investigation.