Endovascular Stent Registry

Background

xrayEndovascular stent grafts are used for the repair of abdominal aortic aneurysm (AAA). The procedure used to place the stent grafts, known as EVAR (endovascular aneurysm repair), was designed initially for patients in poor health unable to undergo open surgical repair, but is now more widely used for treating patients with AAA. Each year, approximately 600 patients are treated with AAA endovascular stents by KP vascular surgeons and/or interventional radiologists. This registry reports EVAR procedures beginning in 2009 to present.


The goals of stent registry are to:

  • Track patients with AAA stent grafts
  • Perform outcomes analysis for clinical best practices
  • Use data elements to support case management of AAA patients
  • Monitor trends in device performance and safety
  • Validate intra-operative surgical events and post-operative complications
Data Collection and Sources

The Endovascular Stent Registry is populated with electronic data from KP HealthConnect (Clarity) as its primary data source and is supplemented with data from other KP administrative databases.

Outcome Validation

In order to record important pre-operative, intra-operative, and post-operative data elements for each procedure entered in the registry, a detailed chart review of the electronic medical record is performed by clinical content experts.

  • Aneurysm: Endoleak (tracked by type and location)
  • Device Malfunction: Component Separation, Device Fracture, Device Migration, Graft Tear, Limb Kinking, Limb Occlusion, Stenosis

In addition, suspected post-operative complications are identified by queries run in the KPHC Clarity database using ICD-9 codes. Identified complications are confirmed through KPHC chart review to determine if they meet pre-established Registry criteria.

  • Aneurysm: Endoleak (tracked by type and location), Rupture
  • Device Malfunction: Component Separation, Device Fracture, Device Migration, Graft Tear, Limb Kinking, Limb Occlusion, Stenosis
  • Revision
  • Secondary Intervention
  • Conversion To Open Repair
  • Infection

An important and unique feature of this registry will be incorporation of a process for post-operative patient surveillance for aneurysm growth.

Reporting

Our annual report includes Endovascular Stent Graft Registry data from the following regions: Northern California, Southern California, Northwest, Hawaii, Colorado, Ohio, and the Mid-Atlantic states. In addition to implant volume data, patient demographics, surgical events, and complications, the annual report includes statistical analysis of device survival rates and patient survival by age, gender and specific disease co-morbidities.