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Assessment of EVAR Complications using CIRSE Complication Classification System in the UK Tertiary Referral Centre: A ∼6-Year Retrospective Analysis (2014–2019)

  • Clinical Investigation
  • ARTERIAL INTERVENTIONS
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Abstract

Purpose

To retrospectively analyse complications in endovascular aortic repair (EVAR) interventions and evaluate if the CIRSE (Cardiovascular and Interventional Radiological Society of Europe) complication classification system is appropriate as a standardized classification tool for EVAR patients.

Materials and Methods

Demographic, procedural and complication data in 719 consecutive patients undergoing EVAR at one institution from January 2014 to October 2019 were retrospectively reviewed. Data (imaging reports, procedural reports, nurse notes, discharge summary reports) were collected consulting the electronic patient record system (EPR) of the hospital and cleaned and stored in a Microsoft Excel database. All the procedures were analysed in consensus by two interventional radiology consultants and a resident radiologist and if an intra- , peri- or post-procedural complication occurred, a grade (1–6) was assigned using the CIRSE grading complication classification system.

Results

Twenty-five patients were excluded from the analysis because of invalid or incomplete data. The final population was made up of 694 patients (mean age 75,4 y.o., 616 male/78 female, min age 23 y.o., max age 97 y.o.). Complications emerged in 211 patients (30,4% of cases, 22 female/189 male). The number of patients with CIRSE grade I, II, III, IV, V and VI complications was 36 (17%), 17 (8%), 121 (57,3%), 15 (7,1%), 3 (1,4%), 19 (9%). Nineteen (2,6%) patients succumbed after EVAR. Thirty-four complications (16,1%) were related to vascular access.

Conclusion

The CIRSE complication classification system represents a broadly applicable and feasible approach to evaluate the severity of complications in patients following EVAR. However, some deficit may be considered relevant and as starting standing-point for future improvements.

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Acknowledgements

These data were submitted as a manuscript and accepted for CIRSE 2020 in September

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. AOUP Paolo Giaccone, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), University of Palermo, Via del Vespro 129, 90123, Palermo, Italy

    Davide Castiglione

  2. Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Box 218, Cambridge, CB2 0QQ, UK

    Akshay Easwaran, Akash Prashar & Nadeem Shaida

  3. AOUP Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy

    Ludovico La Grutta

  4. Areteion Hospital, National and Kapodistrian University of Athens, 76, Vas. Sophias Ave, 11528, Athens, Greece

    Miltiadis Krokidis

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  1. Davide Castiglione
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  6. Nadeem Shaida
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Correspondence to Davide Castiglione.

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Castiglione, D., Easwaran, A., Prashar, A. et al. Assessment of EVAR Complications using CIRSE Complication Classification System in the UK Tertiary Referral Centre: A ∼6-Year Retrospective Analysis (2014–2019). Cardiovasc Intervent Radiol 44, 1174–1183 (2021). https://doi.org/10.1007/s00270-021-02847-9

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