Influence of Obesity on In-Hospital and Midterm Outcomes after Endovascular Repair of Abdominal Aortic Aneurysm

Abstract

Purpose:

To evaluate the influence of obesity on outcomes after endovascular aneurysm repair (EVAR).

Methods:

A retrospective analysis was conducted of 80 patients (77 men; mean age 75.0±7.6 years) undergoing elective EVAR for abdominal aortic aneurysm (AAA) between 2001 and 2008. Patients were stratified on presence of obesity [body mass index (BMI) ≥30 kg/m²). Outcomes in-hospital and during follow-up were compared between obese and non-obese patients.

Results:

In this cohort, 26 (33%) patients had a BMI ≥30 kg/m². Mean BMI in the non-obese group was 25.6 kg/m² versus 34.1 kg/m² in the obese group (p≥0.001). In obese patients, EVAR operating time was longer compared to non-obese patients: 217 versus 177 minutes (p=0.006). One obese patient died after EVAR (p=0.325); the combined operative mortality and major complication rate was 8% (n=2) in the obese group versus 7% (n=4) in the non-obese group (p=NS). Endoleak occurred in 25% (n=6) of the obese group versus 14% (n=7) of the non-obese group (p=0.261). Postoperative intensive care for >24 hours (65% versus 70%, p=0.796) and overall length of stay (3.9 versus 3.8 days, p=0.845) did not differ significantly; neither did all-cause mortality during 2 years of follow-up (p=0.688).

Conclusion:

Obesity is associated with extended operation times during EVAR, but increasing BMI appears to have little influence on outcomes after EVAR. A preferential approach to offering EVAR for obese patients may be reasonable.

Keywords

abdominal aortic aneurysm obesity endovascular aneurysm repair outcome analysis mortality morbidity

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