Heterogeneity in surveillance after endovascular aneurysm repair in the UK

Abstract

Objectives: Surveillance after Endovascular Aneurysm Repair (EVAR) is considered mandatory, but the optimal regimen remains controversial. The aim of the present study was to report the nature of routine post-EVAR surveillance protocols in the UK, in order to identify the degree of variation in national practice and from the manufacturer's instructions for use (IFU).

Methods: A telephone survey was administered to 41 centres with 10 years' experience in EVAR to identify their standard surveillance protocol after EVAR. Data were collected regarding the number of surveillance CT or ultrasound performed up to 5 years postoperatively.

Results: 12/41 centres used CT as the primary mode of surveillance, 14/41 centres used USS as the primary mode of surveillance, and 15/41 centres used a combination of CT and USS. The mean ± s.d. number of CT scans performed cumulatively up to 1 year and 5 years post surgery were 1.1 ± 0.6 and 3.5 ± 2.9 respectively. The mean ± s.d. ultrasound scans performed at 1 year and 5 years post surgery were 0.5 ± 0.9 and 4.7 ± 3.6 respectively.

Conclusions: Significant heterogeneity exists in surveillance after EVAR in the UK. Efforts should be made to establish consensus towards a national surveillance protocol.