{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:49:13Z","timestamp":1790174953665,"version":"4.1.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2016,7,9]],"date-time":"2016-07-09T00:00:00Z","timestamp":1468022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:p>Purpose: To evaluate the outcome and survival of patients with extensive comorbid conditions after endovascular aneurysm repair (EVAR) and objectify which of 2 medical comorbidity classifications is more accurate in predicting adverse outcomes. Methods: All 1263 patients (mean age 73.1 years; 1129 men) treated using the Endurant Stent Graft system and entered in the prospective global postmarketing ENGAGE registry ( ClinicalTrials.gov identifier NCT00870051) were grouped using the American Society of Anesthesiologists (ASA) classification and the Society for Vascular Surgery\/American Association for Vascular Surgery (SVS\/AAVS) medical comorbidity grading system. Patients assigned to ASA III and IV and SVS\/AAVS 2 and 3 categories were considered high risk. Primary outcome was 1-year all-cause mortality. Secondary outcomes included technical and clinical success, major adverse events (MAE), aneurysm rupture, endoleaks, and secondary endovascular procedures. One-year follow-up of the entire ENGAGE cohort was the endpoint of the study. Results: A total of 1263 patients were included. The overall technical success rate was high, the lowest being 97.4% in the ASA I group. The overall 30-day and 1-year Kaplan-Meier survival estimates were 98.7% and 92.5%, respectively. All cause 1-year mortality was higher in the ASA III and IV groups, but this did not reach statistical significance (5.2% and 5.7% for ASA I and II vs 9.0% and 9.9% for ASA III and IV, p=0.12). In the SVS\/AAVS groups, 1-year all-cause mortality significantly increased with the SVS\/AAVS score to 11.3% in the SVS\/AAVS 3 group (p=0.002). There were significantly more MAEs in the SVS\/AAVS 3 group at 1 year (p&lt;0.001 for group 1 vs 3 and group 2 vs 3). Conclusion: Endovascular aneurysm repair has evolved, and high technical success and low mortality and morbidity can be achieved in high-risk patients. When treating high-risk patients, the perioperative risks should always be weighed against the expected gains. In contrast to the ASA classification, the SVS\/AAVS medical comorbidity grading system is a useful tool to predict occurrence of MAEs and 1-year survival in patients undergoing EVAR.<\/jats:p>","DOI":"10.1177\/1526602816648455","type":"journal-article","created":{"date-parts":[[2016,5,11]],"date-time":"2016-05-11T20:28:30Z","timestamp":1462998510000},"page":"574-582","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["One-Year Outcomes of Endovascular Aneurysm Repair in High-Risk Patients Using the Endurant Stent-Graft"],"prefix":"10.1177","volume":"23","author":[{"given":"Martijn L.","family":"Dijkstra","sequence":"first","affiliation":[{"name":"Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands"},{"name":"Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M. M.","family":"van Sterkenburg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Willem","family":"Lardenoye","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clark J.","family":"Zeebregts","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel M. P. J.","family":"Reijnen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the ENGAGE Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,9]]},"reference":[{"key":"bibr1-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.01.007"},{"key":"bibr2-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4529"},{"key":"bibr3-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042002"},{"key":"bibr4-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66627-5"},{"key":"bibr5-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909305"},{"key":"bibr6-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909499"},{"key":"bibr7-1526602816648455","doi-asserted-by":"publisher","DOI":"10.3310\/hta16090"},{"key":"bibr8-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66628-7"},{"key":"bibr9-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0203000516"},{"key":"bibr10-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.123991"},{"key":"bibr11-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1007\/s100169900026"},{"key":"bibr12-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.07.035"},{"key":"bibr13-1526602816648455","author":"Kapma M","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"bibr14-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2010.08.010"},{"key":"bibr15-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.02.009"},{"key":"bibr16-1526602816648455","first-page":"481","volume":"51","author":"B\u00f6ckler D","year":"2010","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"bibr17-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2012.07.005"},{"key":"bibr18-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.01.005"},{"key":"bibr19-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-001-0274-6"},{"key":"bibr20-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.2000.1295"},{"key":"bibr21-1526602816648455","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2003.119"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526602816648455","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1526602816648455","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526602816648455","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:29:47Z","timestamp":1777498187000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1526602816648455"}},"subtitle":["Comparison of the ASA Classification and SVS\/AAVS Medical Comorbidity Grading System for the Prediction of Mortality and Adverse Events"],"short-title":[],"issued":{"date-parts":[[2016,7,9]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1177\/1526602816648455"],"URL":"https:\/\/doi.org\/10.1177\/1526602816648455","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,9]]}}}