E-ISSN 0976-2833 | ISSN 0975-3583
 

Research Article 


Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey.

Abstract
Objective: is to compare results of endovascular management in patients with hostile and
favorable neck infrarenal abdominal aortic aneurysms.Methods: We conducted a non
randomized control study assigning patients with infrarenal abdominal aortic aneurysm (AAA)
treated with commercially available endoprosthesis from January 2019 through January 2020
over one year follow up. Two groups were studied, favorable neck group (FNG, n=17) and
hostile neck group (HNG, n=18). The hostile neck anatomy was defined as, neck length of <15
mm, infrarenal angle of >60, neck diameter of >28 mm, more than 50% circumferential
thrombus, more than 50% calcified neck, and/or reverse taper neck. Endpoints include technical
and assisted technical success, early and late primary outcomes (Endoleak, stent graft patency,
aortic sac expansion, conversion to open repair, stent graft migration, aneurysm rupture,
secondary interventions, and aneurysm-related mortality), and secondary outcomes (operative
blood loss, fluoroscopy time, volume of contrast used, and hospital stay).All outcome measures
were calculated using SPSS version 21.0 (SPSS IBM).Results: The difference in the primary
(FNG=100%, HNG=83%) and assisted primary success, between both groups of patients was
statistically insignificant (p=0.229).We had non-significant statistical difference between both
groups in the incidence of systemic and local complications. There was no graft related mortality
in both groups; also no patient experienced graft migration, endoleak, sac expansion, surgical
conversion or wound complications within 30 days, however Complete thrombotic iliac limb
occlusion occurred in one patient (5.6%) of HNG (P=1.0). One patient (5.6%) in the HNG
experienced graft migration and sac expansion because of type ΙA endoleak. The patient passed
away leading to 5.6% incidence of late graft related mortality (p=1.0). there was significant
increase of hospital stay and the volume of contrast used in the HNG (p = 0.019 and 0.01,
respectively). The difference in technical success between the FNG and the outside the IFU
patients was statistically significant (P=0.024, OR 4.4, 95% CI 2.03-9.5).Conclusion: EVAR in
patients with hostile neck is feasible and effective with an acceptable rate of complications and
increased technical difficulty.

Key words: Abdominal aortic aneurysm, EVAR, Hostile neck, Favorable neck, instruction for use, Endoleak


 
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How to Cite this Article
Pubmed Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. J Cardiovasc. Dis. Res.. 2021; 12(5): 164-177. doi:10.31838/jcdr.2021.12.05.27


Web Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. http://www.jcdronline.org/?mno=107810 [Access: August 08, 2021]. doi:10.31838/jcdr.2021.12.05.27


AMA (American Medical Association) Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. J Cardiovasc. Dis. Res.. 2021; 12(5): 164-177. doi:10.31838/jcdr.2021.12.05.27



Vancouver/ICMJE Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. J Cardiovasc. Dis. Res.. (2021), [cited August 08, 2021]; 12(5): 164-177. doi:10.31838/jcdr.2021.12.05.27



Harvard Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey (2021) Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. J Cardiovasc. Dis. Res., 12 (5), 164-177. doi:10.31838/jcdr.2021.12.05.27



Turabian Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. 2021. Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. Journal of Cardiovascular Disease Research, 12 (5), 164-177. doi:10.31838/jcdr.2021.12.05.27



Chicago Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. "Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia." Journal of Cardiovascular Disease Research 12 (2021), 164-177. doi:10.31838/jcdr.2021.12.05.27



MLA (The Modern Language Association) Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey. "Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia." Journal of Cardiovascular Disease Research 12.5 (2021), 164-177. Print. doi:10.31838/jcdr.2021.12.05.27



APA (American Psychological Association) Style

Marwan Yousry, A.GamilAbdellattif, Mohamed El-Maadawy, M. Hosni, AmrElbahaey (2021) Reactualization of Tourism Destination Management Policy: Good Practices from Indonesia. Journal of Cardiovascular Disease Research, 12 (5), 164-177. doi:10.31838/jcdr.2021.12.05.27





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