Influence of patient-specific rehearsal on operative metrics and technical success for endovascular aneurysm repair

Figures & data

Table 1. Definition of technical success for the intention of this study, based on Chaikof et al.’s [22] reporting standards for EVAR.

Technical success: Based on periprocedural events and the first 24-h postoperatively

Primary technical success: “successful introduction and deployment of the device in the absence of surgical conversion or mortality, type I or III endoleaks, or graft limb obstruction.” [22, p. 1049]

Assisted primary technical success: Successful according to primary technical success but with the use of unplanned endovascular procedure(s)

Technical failure: Not successful according to primary and assisted primary technical success

Table 2. Patient data and operator’s level of experience for all patients.

Characteristics	All patients (n = 60)	PsR group (n = 30)	Control group (n = 30)	p-value
Age	75.6 ± 7.2 (59–88)	75.3 ± 7.8 (59–88)	75.9 ± 6.8 (65–87)	.74^a
Body mass index	26.4; 5.3 (18.7–42.0)	27.2; 6.1 (19.6–42.0)	25.7; 4.7 (18.7–34.1)	.38^b
Female/male	7/53	4/26	3/27	1.0^c
Aneurysm max diameter (mm)	59.5; 9 (33–80)	62.0; 12 (33–80)	59.0; 7 (50–74)	.25^b
Operator’s level of experience: inexperienced/experienced (n = 120 or 60)	32/88	16/44	16/44	1.0^c

PsR and control groups are presented as either mean ± standard deviation (range) or median; interquartile range (range). Sex is presented as total number.

^at-test for equality of means, equal variances, ^bMann–Whitney U test, ^cFischer’s exact test, two-sided.

Figure 1. Boxplots presenting operative metrics for both groups (median (range)). (a) endovascular procedure time (minutes) measured from first angiogram till the last one, p = .017, (b) contralateral gate cannulation time (minutes), p = .785. The time was measured from the moment the operator started manipulating the contralateral catheter in the distal part of the aorta with the intention to cannulate the contralateral limb, and was ended when the operator rotated the catheter at the proximal end of the stent graft thereby verifying that the catheter was within the proximal end of the stent graft, (c) total fluoroscopy time (minutes), p = .255, (d) number of angiograms, p = .392, (e) total radiation dose/dose area product ($\mathrm{mGy}/{\mathrm{m}}^2),$ p = .605, (f) contrast medium use (ml), p = .328. The middle band shows the median value, the bottom and the top of the boxes show the 25th and the 75th percentiles, and the ends of the whiskers show the 5th and the 95th percentiles. Outliers are plotted as circles and extreme outliers as stars.

Figure 2. Final angiograms of the PsR and the real procedure (RP) for two patients: one that ended with primary technical success (patient I) and the one that ended with assisted primary technical success (patient II).

Table 3. Primary and assisted primary technical success, and technical failure rates.

	PsR group (n = 30)	Control group (n = 30)
Primary	28 (93.3%)	23 (76.7%)
Assisted primary	1 (3.3%)	4 (13.3%)
Technical failure	1 (3.3%)	3 (10%)

p value Mann–Whitney U test .076.

Chaikof EL, Blankensteijn JD, Harris PL, et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg. 2002;35(5):1048–1060.

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