Characteristic of the aortic for endovascular aneurysm repair in Indonesian population in five years experiences

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Abstract

Objectives Indonesia has had an emerging endovascular treatment during this last half decade, especially for aortic. With only thirty-nine vascular surgeons we havefor 261.1 million populations, many cases had beentreated by us. Despite some cases also were treatedby other specialties. During these five years, we collected data from endovascular aneurysm repair(EVAR) treatment. The aim of this study is to deliver our experience treating patients with endovascular treatment in aortic diseases and also to providethe aortic morphology of EVAR patients. Methods This is a retrospective study of the abdominal aorticaneurysm (AAA) patients that were treated byEVAR. The data was collected by the third partyfrom twelve vascular centers in Indonesia during 2012-2017. Patient demographics and computed tomography data were evaluated with Osirix MD software and analyzed by SPSS 25 (IBM). Results During 5 years we had 148 EVAR cases was doneusing Endurant stent graft (Medtronic). Due to lackof complete data, we excluded 54 cases. The evaluation of 94 patients revealed 76.6% was male withmean age of 67.8 ± 9.9 years old, and 17% of themwere treated both for an abdominal and thoracic aneurysm. All of them had a fusiform with 14.9% dissected which more than half were infra-renal (72.3%) and had >50% intra-mural thrombus in theaneurysmal sac (57.4%). Mean values of proximalneck length, diameter, and angle were 26.8 ± 16.7mm, 21.0 ± 5.9 mm, 41.3 ± 19.9 degree, res pectively, with 4 patients had less than 10 mm in necklength. The maximum diameter of aneurysmal sacwas 57.0 ± 22.1 mm in average. Most aneurysmalsac didn’t have common iliac artery involvement,only 19.1% occurred in both arteries. Eleven percent patients had external iliac artery circumferential thrombus >50% which occurred either on theleft or right side. Sealing zone in both CIA less than15 mm was none. Conclusions EVAR in Indonesia started in 2012 with only 4cases. Despite being relatively new, many cases ofEVAR have been managed in our centers in Indonesia during the last 5 years. The treatment was increasing almost doubled every following year. Mostcases were done by vascular surgeons with referralsystem to particular university hospitals. Aorticcharacteristic for AAA in Indonesia has commonfeatures, nevertheless, those were relatively longproximal neck and the huge size of the aneurysmalsac in particularly young age. Health care systemand insurance in Indonesia could be the factor forlate diagnosed.
Original languageEnglish
Title of host publication19th Congress of Asian Society for Vascular Surgery
Publication statusPublished - Jul 2018

Keywords

  • aortic characteristic
  • EVAR
  • Indonesia

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