National Vascular Registry

AAA Repair

Patient Details

Patient Consent* 0 No 1 Yes 2 Not Required If patient not consented:

Date consent recorded ____ /____ /________ (DD/MM/YYYY) Do not record NHS number,
NHS number* ___________________ name(s) or postcode.
Date of birth* ____ /____ /________ (DD/MM/YYYY) If consent not required:
Sex* 1 Male 2 Female Ignore consent date.
Last name ______________________________________
First name ______________________________________

Postcode* ___________________

Admission Details

Admission date* ____ /____ /________ (DD/MM/YYYY)

Mode of admission* 1 Elective 2 Non-elective

Hospital code* Pre-populated drop down menu on NVR audit site

Local ID* ___________________

Procedure type Abdominal Aortic Aneurysm Repair

Pre-operative: Pathway

Elective Non-elective

Indication for intervention Prior contact

0 ≥5.5 screen detected aneurysm (NAAASP) 0 Not known
1 ≥5.5 screen detected aneurysm (non NAAASP) 1 Yes, on surveillance
2 ≥5.5 lesion non-screen detected aneurysm 2 Yes, not for elective repair
3 Symptomatic 3 Yes, on waiting list or booked for
surgery
4 Rapid growth
…continued on next page
5 Other threshold

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AAA Threshold ____ /____ /________ …continued from previous page
(DD/MM/YYYY)
CT/MR angio ____ /____ /________
assessment date (DD/MM/YYYY)
MDT discussion date ____ /____ /________
(DD/MM/YYYY)

Anaesthetic Assessment (for Elective Pathway only)

Date of Anaesthetic review ____ /____ /________ (DD/MM/YYYY)

Consultant vasc anaesthetist review

0 No 1 Yes

Fitness measurement used*

0 None
1 CPET
2 Incremental shuttle walk test
3 6 Minute walk test
4 Dynamic test of cardiac function
5 Echo +/- pulmonary function tests

Investigation after preop anaesthetic assessment*

1 No additional investigation /intervention
2 Referral to another specialty
3 Further investigations required
4 Optimization in drug therapy

For both Elective and Non-elective pathways

Patient weight* ___________________ in Kg

Patient height* ___________________ in cm

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Indications

AAA/Aortic Diameter* ___________________ in mm

Previous Aortic op* 0 No 1 Open repair

2 Endovascular repair 3 AAA repair – type unknown
4 Both open and endovascular repair

Risk Scoring

Comorbidities* 0 None
1 Diabetes
2 Hypertension
3 Chronic lung disease
4 Ischaemic heart disease
Please select as 5 Chronic heart failure
many options 6 Chronic renal disease
as applicable. 7 Stroke

Smoking status* 1 Current or stopped 2 Ex-smoker 3 Never smoked

within 2 months

White cell count* ___________________ (x109/l)

Sodium* ___________________ (mmol/l)
Potassium* ___________________ (mmol/l)
Creatinine* ___________________ (µmol/l)
Albumin ___________________ (g/l)
Haemoglobin* ___________________ (g/dl)

Abnormal ECG* 0 Normal 1 Abnormal

ASA Grade* 1 1 – Normal

2 2 – Mild disease
3 3 – Severe, not life-threatening
4 4 – Severe, life-threatening
5 5 – Moribund patient

Pre-operative 0 None 4 ACE inhibitor / ARB

medication* 1 Anti-platelet 5 Antibiotic prophylaxis
2 Statin 6 DVT prophylaxis
3 Beta blocker

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Procedure: AAA Repair

Date/Time start ____ /____ /________ (DD/MM/YYYY); ____ : ____ (HH:MM)

Aortic status* 1 Asymptomatic 4 Aortic transection

2 Symptomatic unruptured 5 Acute dissection
3 Ruptured 6 Chronic dissection

Type of repair* 1 Open 4 Revision Open

2 EVAR 5 Revision EVAR (See relevant sections below)
3 Complex EVAR 6 EVAS (See relevant sections below)

OPCS code of procedure 1* ___________________ All options will be available on NVR

OPCS code of procedure 2 ___________________ audit site via drop down menus.
OPCS code of procedure 3 ___________________

Open

AAA Clamp site 1 Infra-renal AAA Graft 1 Tube

2 Supra-renal 2 Bifurcate iliac
3 Supra-mesenteric 3 Bifurcate groin
4 Supra-coeliac 4 Uni-iliac and crossover
5 Thoracic aorta

EVAR & EVAS Complex EVAR – Additional items

EVAR exclusion* 0 No Type of 1 FEVAR

1 Yes primarily complex 2 BEVAR
2 Yes after adjunctive EVAR 3 TEVAR
procedures
4 Iliac branched graft
5 Composite graft
Neck angle 1 0 to 60 degrees
6 Chimney/periscope/snorkel
2 60 to 75 degrees
3 75 to 90 degrees Iliac branch
4 More than 90 degrees 0 No 1 Right 2 Left 3 Bilateral

Neck diameter ______________ in mm Note: If complex EVAR is 3=TEVAR, then the following
Neck length ______________ in mm questions won’t appear on the screen: iliac branch, neck
angle, neck length, extended into external iliac artery,
…continued on next page common iliac artery diameter

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Extended External 0 No …continued from previous page
1 Right Endoleak
Iliac Artery (EIA) 2 Left

3 Bilateral Endoleak type* 0 No endoleak

1 Type 1
Common Iliac Artery 2 Type 2
(CIA) diameter _______________ in mm
3 Type 3
4 Type 4
EVAS – Additional items 5 Unclassified

Type of EVAS device If NO endoleak ignore the next 2 items.

1 Standard
Endoleak intervention 0 No 1 Yes
2 Chimney/periscope/snorkel
Success 0 No 1 Yes

Operator

Vascular specialist 1* ___________________ Anaesthetist 1* ___________________

Vascular specialist 2 ___________________ Anaesthetist 2 ___________________
Vascular specialist 3 ___________________
Vascular specialist 4 ___________________

Peri-operative Anaesthetic Details

Anaesthetic type* 1 Local anaesthetic 4 GA plus regional anaesthetic
2 Regional anaesthetic 5 GA plus peripheral nerve blockade
3 General anaesthetic 6 Regional plus peripheral nerve blockade

Direct arterial monitoring 0 No 1 Yes

Intraoperative cardiac output monitoring 0 No 1 Yes

Postoperative coagulopathy 0 No 1 Yes

Core temperature ≥ 36 oC at end of procedure 0 No 1 Yes
Patient reported severe pain within 1 hour of surgery 0 No 1 Yes
Postoperative vomiting within 3 hours of surgery 0 No 1 Yes

Post Operative

Note: If Died in theatre is selected,

Destination after surgery* 1 Ward
the remaining questions in the
2 Level 2 (HDU/PACU) post-operative section will not
show
4 Level 3 (ICU)
5 Died in theatre

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Critical care stay* ___________________ (Number of days)

Return to theatre within admission* 0 No 1 Yes

Readmission to a higher level of care* 0 No 1 Yes

Postoperative complications* 0 None

1 Cardiac (MI / NSTEMI / heart failure)
2 Respiratory
3 Cerebral (stroke)
4 Renal failure
Please select as many 5 Haemorrhage
options as applicable. 6 Limb ischaemia
7 Paraplegia
8 Bowel ischaemia

Discharge

Discharge status – Alive on discharge* 0 No 1 Yes

Date discharged/died* ____ /____ /________ (DD/MM/YYYY)

Anaesthetic Details

All items shown in this screen are pre-populated from the information you have recorded in the following
sections:
 Anaesthetic Assessment (Page2)
 Peri-operative Anaesthetic Details (Page 5)

Follow Up

Readmission to hospital within 30 days 0 No 1 Yes

Reason for NO follow up 1 Died prior to planned follow-up after discharge

2 Moved out of area
3 Did not attend
4 Other

Date clinic appointment attended ____ /____ /________ (DD/MM/YYYY) (Only if follow up occurred)

If you have any queries please contact us on 020 7869 6621 and nvr@rcseng.ac.uk

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