Tóm tắt

Background: Endovascular aortic repair (EVAR) is a minimally invasive treatment for aortic pathologies, but implementing it in Vietnam’s resource-constrained provincial hospitals faces challenges like limited expertise and infrastructure. This study evaluates the safety and feasibility of an EVAR program at Dong Nai General Hospital.

Methods: This retrospective cohort study analyzed 33 patients undergoing EVAR from April 2021 to April 2025. Data on demographics, risk factors, aortic regions, procedure types, and short-term outcomes were collected. Subgroup analyses by aortic region, debranching type, and hybrid approach used Fisher’s exact test. Logistic regression assessed complication predictors.

Results: The cohort (81.8% male, mean age 71.2 years, 78.8% hypertensive, 60.6% dyslipidemic, 72.7% smokers) had a 3.0% mortality rate (1/33, arch-related) and 18.2% complication rate (6/33). Complications included type II endoleaks (9.1%, 3/33, conservatively managed), stroke (3.0%, 1/33), reoperation for bleeding (3.0%, 1/33), and prolonged ventilation (6.1%, 2/33). Thoracoabdominal (100%, 1/1) and visceral debranching (100%, 1/1) had the highest complication rates; infrarenal was lowest (7.7%, 1/13). Visceral debranching significantly predicted complications (OR=3.5, 95% CI: 1.2–10.5; p=0.03).

Conclusion: EVAR is safe and feasible in Vietnam’s provincial hospitals, with manageable complications. Strategic training, volume increase, and infrastructure investment are crucial for sustainability.