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ANZSVS Conference 2026
Can Elective Infrarenal EVAR Patients Safely Avoid Routine High Dependency Admission? A Retrospective Cohort Study.
Poster

Poster

Disciplines

Vascular Surgery

Presentation Description

Institution: Westmead Hospital - NSW, Australia

Purpose Routine high-dependency/intensive care unit (HDU/ICU) admission following elective endoluminal aortic aneurysm repair (EVAR) has historically been standard practice; however, contemporary evidence suggests this may unnecessarily utilise critical care resources. We aimed to evaluate postoperative care requirements following standard elective EVAR. Methodology A retrospective review was performed of patients undergoing elective infrarenal EVAR at Westmead Hospital from 01/20–03/26. Patients not undergoing standard elective infrarenal EVAR (eg ruptured EVAR, fenestrated repair) were excluded. Demographic, comorbidity and perioperative data were collected. The primary outcome was requirement for HDU/ICU-level intervention postoperatively. Results A total of 130 patients were included. Median age was 75 and median ASA score was 3. Though 123 patients (94.6%) were routinely admitted to HDU/ICU, only 14 (10.8%) required ICU/HDU-level intervention. All patients who bypassed HDU/ICU spent at least 12 hours in the recovery ward. Enhanced postoperative care was clinically required for vasopressor support (3.1%), non-invasive ventilation (3.1%), invasive ventilation (1.5%) and haemodynamically-significant arrhythmia management (1.5%). One patient required ICU monitoring for a day-0 postoperative retrograde aortic dissection, and another for severe pain. Patients did not spend long in these settings, with a mean stay of 2.1 days, and 30.8% of patients being discharged directly from HDU/ICU. No preoperative factors significantly predicted ICU/HDU requirement, although COPD and poor preoperative renal function trended toward significance. Conclusion Most patients undergoing elective infrarenal EVAR did not require postoperative HDU/ICU-level care despite routine admission. Selective utilisation of ICU resources following EVAR may streamline healthcare resource allocation though larger studies are required to profile patients who will benefit from planned HDU/ICU admission.
Speakers
Authors
Authors

Ms Jenny Jung - , Dr Asanka Wijetunga - , Dr Paul Ghaly - , Dr Tom Daly - , A/Prof Mauro Vicaretti -