Abdominal aortic aneurysms—A national multicentre study

Amundsen, S; Trippestad, Arne; Viste, Asgaut; Søreide, Odd

doi:10.1016/s0950-821x(87)80074-9

Cited by 33 publications

(13 citation statements)

References 13 publications

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“…Since the introduction of open repair of AAAs, the mortality rate has decreased from approximately 10% in its early days to below 5% in contemporary institutional series. 6,7,20,21 On the other hand, in regional and national surveys, the reported mortality rate is still between 6% and 10%. 5 Approximately 40% to 70% of perioperative deaths are due to cardiac causes.…”

Section: Discussionmentioning

confidence: 99%

“…OAR is associated with a mortality rate of approximately 4% in institutional series and 6% to 10% in regional or national studies. [5][6][7][8] Coronary artery disease (CAD), the most prominent risk factor, is responsible for up to 60% of perioperative deaths after OAR. 6,7,9 Adverse cardiac events have been attributed to excessive stress on the myocardium caused by the combined effect of anesthetic induction, aortic clamping and declamping, operative blood loss, and associated hemodynamic and metabolic changes.…”

mentioning

confidence: 99%

“…[5][6][7][8] Coronary artery disease (CAD), the most prominent risk factor, is responsible for up to 60% of perioperative deaths after OAR. 6,7,9 Adverse cardiac events have been attributed to excessive stress on the myocardium caused by the combined effect of anesthetic induction, aortic clamping and declamping, operative blood loss, and associated hemodynamic and metabolic changes. 10,11 It is likely that hemodynamic alterations associated with endovascular aneurysm repair (EAR) are less severe.…”

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confidence: 99%

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Cardiac response and complications during endovascular repair of abdominal aortic aneurysms: A concurrent comparison with open surgery

Cuypers¹,

Gardien²,

Buth³

et al. 2001

Journal of Vascular Surgery

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Hemodynamic alterations during endovascular repair were not as severe as those in patients with open surgery and indicated less myocardial stress in the former category. These findings may explain a lower incidence of myocardial ischemia that was observed during endovascular repair. A lower frequency of clinical perioperative cardiac events in patients undergoing endovascular treatment may ultimately be expected.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Cardiac response and complications during endovascular repair of abdominal aortic aneurysms: A concurrent comparison with open surgery

Cuypers¹,

Gardien²,

Buth³

et al. 2001

Journal of Vascular Surgery

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“…47 Results of other population-based studies are similar. [54][55][56][57][58][59][60] Surprisingly, there also appears to have been little improvement in mortality rates for elective or ruptured AAA repair over the past two decades. 33,47,49 Although such generalized experience is important, decision making for individual patients requires a more patient-specific approach.…”

Section: Operative Riskmentioning

confidence: 99%

Guidelines for the treatment of abdominal aortic aneurysms: Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery

Brewster

Cronenwett

Hallett

et al. 2003

Journal of Vascular Surgery

730

414

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Decision-making in regard to elective repair of abdominal aortic aneurysms (AAA) requires careful assessment of factors that influence rupture risk, operative mortality, and life expectancy. Individualized consideration of these factors in each patient is essential, and the role of patient preference is of increasing importance. It is not possible or appropriate to recommend a single threshold diameter for intervention which can be generalized to all patients. Based upon the best available current evidence, 5.5 cm is the best threshold for repair in an "average" patient. However, subsets of younger, good-risk patients or aneurysms at higher rupture risk may be identified in whom repair at smaller sizes is justified. Conversely, delay in repair until larger diameter may be best for older, higher-risk patients, especially if endovascular repair is not possible. Intervention at diameter <5.5 cm appears indicated in women with AAA. If a patient has suitable anatomy, endovascular repair may be considered, and it is most advantageous for older, higher-risk patients or patients with a hostile abdomen or other technical factors that may complicate standard open repair. With endovascular repair, perioperative morbidity and recovery time are clearly reduced; however, there is a higher reintervention rate, increased surveillance burden, and a small but ongoing risk of AAA rupture. There is no justification at present for different indications for endovascular repair, such as earlier treatment of smaller AAA. Until long-term outcome of endoluminal repair is better defined and results of randomized trials available, the choice between endovascular and open repair will continue to rely heavily on patient preference.

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“…Operationstechnisch stehen zwei Verfahren zur Verfügung: Zum einen der geschilderte Simultaneingriff, zum anderen das zweizeitige Vorgehen. bei Vorliegen einer Symptomatik [6], so daß der im CT beschriebene Durchmesser von 8 cm eine In-tervention dringend erforderlich machte [1]. Dieses wäre aufgrund der Voroperation nur ü ber einen posterioren Zugang und z.…”

Section: Diskussionunclassified

Die einzeitige retroperitoneale Operation eines juxtarenalen Bauchaortenaneurysmas und einer ischämischen Wirbelkörpernekrose

Kolvenbach

Lohmann

Siegling³

1997

Chirurg

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The combination of abdominal aortic aneurysm (AAA) and necrosis of the lumbar vertebral bodies is often the consequence of ischemia of the lumbar arteries and local compression from the aneurysm. A patient with necrosis of lumbar vertebral bodies 2 to 4 was admitted for abdominal aneurysm repair. CT scanning revealed almost complete destruction of the second and fourth lumbar vertebral bodies. In a combined operation an orthopedic and a vascular surgical team implanted two carbonic cages with autogenous splinter of the pelvic bone and an aortic vascular graft, using a retroperitoneal approach. Three months after the operation the 61-year-old man is entirely well and without any signs of back pain. He could be fully mobilized within 3 weeks postoperatively. This case study depicts the surgical techniques and discusses the advantages of the simultaneous operation and retroperitoneal exposure.

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Abdominal aortic aneurysms—A national multicentre study

Cited by 33 publications

References 13 publications

Cardiac response and complications during endovascular repair of abdominal aortic aneurysms: A concurrent comparison with open surgery

Cardiac response and complications during endovascular repair of abdominal aortic aneurysms: A concurrent comparison with open surgery

Guidelines for the treatment of abdominal aortic aneurysms: Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery

Die einzeitige retroperitoneale Operation eines juxtarenalen Bauchaortenaneurysmas und einer ischämischen Wirbelkörpernekrose

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