{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:41:37Z","timestamp":1790127697870,"version":"4.0.1"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Guidelines recommend annual imaging surveillance after endovascular abdominal aortic aneurysm repair (EVAR). How these guidelines translate into practice among veterans remains poorly described.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To characterize post-EVAR surveillance among veterans.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study evaluated veterans who underwent EVAR between January 1, 2000, and December 31, 2023, at US Department of Veterans Affairs (VA) hospitals and received follow-up care at VA and non-VA hospitals and imaging centers with payment via Medicare or the VA. Veterans treated with EVAR in VA hospitals during the study period were included.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Years after EVAR.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was annual surveillance adherence, measured as 1 or more imaging studies in the abdomen or pelvis each year after EVAR. Stepwise logistic regression modeling was used to determine factors associated with poor adherence. Secondary outcomes were imaging type (cross-sectional, ultrasonography, or ultrasonography followed by cross-sectional imaging) and factors associated with lower adherence.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The cohort included 27\u202f792 veterans (27\u202f624 male [99.4%]; 22\u202f521 aged \u226565 years [81.0%]). Mean (SD) follow-up was 6.0 (4.0) years. The mean (SD) proportion of time that veterans were surveillance adherent was 71.1% (28.5%). Surveillance was initially high, with 25\u202f026 of 27\u202f792 veterans (90.0%) undergoing surveillance imaging in year 1 after EVAR. However, this proportion decreased further out from EVAR, with 12\u202f401 of 21\u202f384 veterans (58.0%) undergoing surveillance imaging by year 4 after EVAR. Veterans were most likely to undergo imaging with computed tomography scans (21\u202f911 veterans [78.8%]). However, the proportion with surveillance via ultrasonography alone increased from 823 of 25\u202f026 veterans (3.3%) in year 1 after EVAR to 2567 of 12\u202f401 veterans (20.7%) in year 4 after EVAR. White race (odds ratio [OR] vs all other racial groups, 0.84; 95% CI, 0.72-0.98), married status (OR vs all other social status categories, 0.80; 95% CI, 0.71-0.89), having a service-connected disability (OR, 0.69; 95% CI, 0.62-0.77), and a higher Charlson Comorbidity Index score (OR per 1-unit increase, 0.93; 95% CI, 0.91-0.95) were associated with lower odds of poor surveillance adherence.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, post-EVAR imaging surveillance was high, although surveillance lapses were more likely further out from EVAR and for patients with certain characteristics. This information may inform future patient-centered efforts to improve post-EVAR imaging adherence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.6852","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T11:31:12Z","timestamp":1745494272000},"page":"e256852","source":"Crossref","is-referenced-by-count":8,"title":["Imaging Surveillance Adherence After Endovascular Abdominal Aortic Aneurysm Repair at VA Hospitals"],"prefix":"10.1001","volume":"8","author":[{"given":"Laura E.","family":"Newton","sequence":"first","affiliation":[{"name":"Department of Surgical Services, Veterans Affairs Medical Center, White River Junction, Vermont"},{"name":"Department of General Surgery, Dartmouth Health, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind","family":"Ponukumati","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Dartmouth Health, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Zwain","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, Veterans Affairs Medical Center, White River Junction, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Korves","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program, Veterans Affairs Medical Center, White River Junction, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialin","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Dartmouth Health, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shipra","family":"Arya","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Stanford University School of Medicine, Palo Alto, California"},{"name":"Section of Vascular Surgery, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olamide","family":"Alabi","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery and Endovascular Therapy, Emory University Hospital, Atlanta, Georgia"},{"name":"Surgical and Perioperative Services, Atlanta Veterans Affairs Healthcare System, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Scali","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville"},{"name":"Division of Vascular Surgery, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Greenleaf","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Baylor College of Medicine, Houston, Texas"},{"name":"Department of Surgery, Michael E. 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