Effect of anticoagulation and antiplatelet therapy on incidence of endoleaks and sac size expansions after endovascular aneurysm repair.

Abstract

BACKGROUND:

The effects of anticoagulation or antiplatelet therapy on the incidence of endoleak and aneurysm sac size after endovascular aneurysm repair (EVAR) are unclear. This study aims to determine whether these therapies affect the incidence of endoleaks or sac size expansions after EVAR.

METHODS:

The case notes of 407 patients (367 men and 40 women, mean age 74.7 years) who underwent elective EVAR between January 2006 and November 2011 were reviewed for medication history and EVAR-related outcomes.

RESULTS:

The median follow-up period was 18 months. There were 45 (11.1%) patients on warfarin (WA), 292 (71.7%) on antiplatelet therapy (AT) (aspirin, clopidogrel, or dipyridamole modified release), and 70 (17.2%) on no anticoagulation or antiplatelet therapy (NA). During the study period, 51 (12.5%) endoleaks were documented, 8 type I (AT = 6, NA = 0, and WA = 2) and 42 type II (AT = 31, NA = 9, and WA = 2). Medication did not significantly affect the incidence of type I (P = 0.24) (based on chi-squared analysis), type II (P = 0.33), or type III (P = 0.82) endoleaks, or sac expansions (P = 0.95).

CONCLUSIONS:

Warfarin and antiplatelet therapies are not associated with increased incidence of postoperative endoleaks or aneurysm sac expansion after EVAR. The data in this study support safe use of anticoagulant and antiplatelet medications in patients undergoing EVAR.

• Authors: John B Wild, Nikesh Dattani, Phillip Stather, Matthew J Bown, Robert D Sayers, Edward Choke
• Journal: Annals of vascular surgery (Ann Vasc Surg) Vol. 28 Issue 3 Pg. 554-9 (Apr 2014) ISSN: 1615-5947 [Electronic] Netherlands
• PMID: 24090829 (Publication Type: Journal Article)
• Copyright: Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anticoagulants
• Platelet Aggregation Inhibitors

Topics

• Adult
• Aged
• Aged, 80 and over
• Aneurysm (surgery)
• Anticoagulants (adverse effects, therapeutic use)
• Blood Vessel Prosthesis Implantation (adverse effects)
• Chi-Square Distribution
• Endoleak (diagnosis, epidemiology)
• Endovascular Procedures (adverse effects)
• England (epidemiology)
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Platelet Aggregation Inhibitors (adverse effects, therapeutic use)
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome