Polling Station

Poll 13/04/2018 – 30/06/2018

Topic: Asymptomatic juxta- and pararenal aortic aneurysms

Patient’s characteristics

Gender: Female
Age: 75 years old
Comorbidity: Arterial hypertension, hypercholesterinemia, previous aortocoronary bypass grafting, previous myocardial infarction, previous smoker, peripheral arterial disease, atrial fibrillation
Symptoms: None
Previous operations: None

 

Aneurysm characteristics:

Max. aneurysm diameter: 54 mm

Length of proximal infrarenal neck: 0 mm

Distance between SMA and LRA: 20 mm

Diameter of renal arteries: RRA: 5,3 mm, LRA: 6 mm

Suprarenal angulation: 60°

Diameter of distal neck: 30 mm

Minimum diameter of common iliac arteries: R: 11 mm, L:9 mm

Maximum diameter of common iliac arteries: R: 11 mm, L: 14 mm

Minimum diameter of external iliac arteries: R: 7 mm, L: 6,2 mm

Question #1

What would be your treatment strategy in this case?
  • Open surgical repair
  • fEVAR
  • chEVAR
  • Branched endografting
  • Conservative treatment and follow-up
Question #2

Which diameter is an indication for the open or endovascular treatment of a juxta- or pararenal AAA in your daily practice?
  • ≥50mm
  • ≥55mm
  • ≥60mm
Question #3

Which criterion is the most important to decide between fEVAR and chEVAR in a patient with an asymptomatic juxta- or pararenal AAA and appropriate anatomy for both procedures?
  • Comorbidity
  • Age
  • Costs
  • If fEVAR is feasible, chEVAR should not be used in asymptomatic patients
Question #4

Do you use the Vascular Quality Initiative (VQI) perioperative mortality risk score in your daily practice?
  • Yes
  • No
  • I am not familiar with the VQI risk score
Question #5

Which is approximately the percentage of chEVAR procedures for asymptomatic juxta-/suprarenal aortic aneurysms in your daily practice?
  • I am not familiar with the chEVAR technique
  • < 10%
  • 10-40%
  • 40-70%
  • > 70%
Question #6

Which is approximately the percentage of fEVAR procedures for asymptomatic juxta-/suprarenal aortic aneurysms in your daily practice?
  • I am not familiar with the fEVAR technique
  • < 10%
  • 10-40%
  • 40-70%
  • > 70%
Question #7

Which is approximately the percentage of open surgery for asymptomatic juxta-/suprarenal aortic aneurysms in your daily practice?
  • I am not a surgeon and I am not referring patients to vascular surgeons
  • < 10%
  • 10-40%
  • 40-70%
  • > 70%
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