Abstract
Evidence for different surveillance protocols following aortic treatment is still lacking. Aim of this study was to analyze the clinical relevance of a first follow-up visit after 6 months. Between 01/2018 and 12/2019, 464 patients treated for non-emergent aortic pathologies were retrospectively analysed. Incidence of aortic events during follow-up (ie death, reintervention, endoleaks, anastomotic/new aneurysms, and diameter progression over time) was investigated. A discrete-time non-homogeneous Markov-chain model was used to analyse the data and to arrive at the number of skipped 6-month follow-up visits needed to harm a patient. After 6 months 2 (1.77%) patients had died, 15 (15.31%) patients suffered from aortic events, and a total of 4 (3.67%) patients had undergone reintervention after endovascular surgery, compared to 0 deaths, 2 (0.59%) patients with aortic events and 5 (1.48%) reinterventions after open-surgery. In our Markov Chain Model, after 6 months, 4.75% of patients showed aortic events, received a reintervention, or died. Sixty patients would need to skip their 6-month follow-up visit for one indication for reintervention to go unnoticed. Only 24 would need to skip it for one complication to go by unnoticed. This number is 55 after open surgery and 9 after endovascular. After elective endovascular or open aortic surgery without immediate in-hospital postoperative aortic events, the first follow-up visit after 6 months is important. Extending the first interval to longer time periods might lead to a considerable increase in missed aortic events. The cost and radiation exposure of frequent follow-ups must be balanced against the benefits of early preventative aortic interventions, warranting further research.
Published Version
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