Non-Cardiac Vascular (Aortic Aneurysm) Quality-Based Procedure Clinical Handbook - Revised December 2024

Oct 5, 2026

Uploaded by Asher

Ontario Health and the Ministry of Health present a Quality-Based Procedure Clinical Handbook focused on non-cardiac vascular care for aortic aneurysm. The handbook provides the purpose and introduction to quality-based procedures, including an evidence-based framework, feasibility, cost impact, and how the model supports innovation. It defines patient groups and inclusion/exclusion criteria, describes elective and non-elective repair and EVAR pathways, and outlines initial rationale, wait-time considerations, risk-adjusted outcomes, centralization, and technology utilization. It further details best-practice clinical pathways and implementation guidance, along with revision histories.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages56

Reading Time2 h 21 min

AccessFree to download

List of Abbreviations

Preface

Ontario Health

December 2024 Revision Summary

March 2022 Revision Summary

Table 1. Summary of March 2022 Updates to AA Groupings

I. Inclusion of Non-Elective Procedures

II. Inclusion of Advanced Aortic Aneurysm Repair Procedures

III. Code Revisions

February 2021 Revision Summary

Inclusion of Same Day (Outpatient) Procedures

October 2018 Revision Summary

Code Revisions

Table 2. 2018 Coding Revisions

1.0 Purpose

2.0 Introduction to Quality-Based Procedures

Figure 1. Evidence-Based Framework for QBPs

Practice Variation

Availability of Evidence

Feasibility/Infrastructure for Change

Cost Impact

2.1 How Will QBPs Encourage Innovation?

3.0 Description of this QBP

3.1 Patient Groups

Table 3. AA Repair Groupings

3.2 Inclusion and Exclusion Criteria

Table 4. Elective AA Repair

Table 5. Non-Elective AA Repair

Table 6. Elective Juxtarenal EVAR with Fenestrated Graft (NEW)

Table 7. Non-Elective Juxtarenal EVAR with Fenestrated Graft (NEW)

Table 8. Advanced Elective AA Repair

Table 9. Advanced Non-Elective AA Repair

3.3 Initial Rationale for Choosing this QBP

Table 10. Evidence-Based Framework for Aortic Aneurysm Repair

3.4 Initial Application of the Evidence-Based Framework

Wait Times

Risk-Adjusted Clinical Outcomes

Centralization

Technology Utilization

3.5 Initial Objectives of this QBP

3.6 Documentation and Clinician Engagement

4.0 Best Practices to Guide Implementation

4.1 Best-Practice Clinical Pathways

Figure 2. Treatment of Asymptomatic Aortic Aneurysm

Figure 3. Treatment of Symptomatic Aortic Aneurysm

ONTARIO HEALTH AND MINISTRY OF HEALTH Quality-Based Procedure Clinical Handbook Non-Cardiac Vascular (Aortic Aneurysm) REVISED DECEMBER 2024 Table of Contents List of Abbreviations ....................................................................................................................... 5 Preface ............................................................................................................................................ 8 Ontario Health ............................................................................................................................ 8 December 2024 Revision Summary ............................................................................................ 8 March 2022 Revision Summary .................................................................................................. 9 Table 1. Summary of March 2022 Updates to AA Groupings ............................................... 10 I. Inclusion of Non-Elective Procedures ................................................................................ 11 II. Inclusion of Advanced Aortic Aneurysm Repair Procedures ............................................ 12 III. Code Revisions ................................................................................................................. 13 February 2021 Revision Summary ............................................................................................ 13 Inclusion of Same Day (Outpatient) Procedures .................................................................. 13 October 2018 Revision Summary ............................................................................................. 15 Code Revisions ...................................................................................................................... 15 Table 2. 2018 Coding Revisions............................................................................................. 15 1.0 Purpose ................................................................................................................................... 17 2.0 Introduction to Quality-Based Procedures ............................................................................. 18 Figure 1. Evidence-Based Framework for QBPs.................................................................... 19 Practice Variation .................................................................................................................. 19 Availability of Evidence ......................................................................................................... 19 Feasibility/Infrastructure for Change.................................................................................... 20 Cost Impact ........................................................................................................................... 20 Quality-Based Procedure Clinical Handbook for Lower Extremity Occlusive Disease 2 2.1 How Will QBPs Encourage Innovation? .............................................................................. 20 3.0 Description of this QBP ........................................................................................................... 21 3.1 Patient Groups .................................................................................................................... 21 Table 3. AA Repair Groupings ............................................................................................... 22 3.2 Inclusion and Exclusion Criteria .......................................................................................... 23 Table 4. Elective AA Repair (Standard and Moderate, excluding Juxtarenal EVAR) ............ 23 Table 5. Non-Elective AA Repair (Standard and Moderate, excluding Juxtarenal EVAR) .... 25 Table 6. Elective Juxtarenal EVAR with Fenestrated Graft (NEW) ........................................ 26 Table 7. Non-

FAQs

What is the purpose of the Quality-Based Procedure clinical handbook for non-cardiac vascular aortic aneurysm care?

It sets out the purpose of quality-based procedures and frames how care should be organized and evaluated for aortic aneurysm across patient groups and procedure types.

How does the handbook define patient groups and which repairs are included?

It describes patient groupings and applies inclusion and exclusion criteria, then organizes pathways for elective and non-elective aortic aneurysm repair as well as juxtarenal EVAR approaches with fenestrated grafts, including advanced repair categories.

Which evidence-based elements guide implementation and quality expectations?

The handbook uses an evidence-based framework and covers availability of evidence, feasibility/infrastructure for change, cost impact, wait times, risk-adjusted clinical outcomes, centralization, and technology utilization.

Oct 5, 2026

Uploaded by Asher