Comparative outcomes of open abdominal therapy after ruptured abdominal aortic aneurysm via open and endovascular approaches

Steenberge, Sean P.; Sorour, Ahmed A.; Sundaram, Abishek; Bena, James; Kirksey, Lee

doi:10.1016/j.avsg.2021.05.013

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…The literature has shown that patients with an rAAA who undergo EVAR have shorter hospital and ICU stays compared with open repair, and our data demonstrated a similar trend. 13,[40][41][42][43][44] However, both hospital and ICU length of stay increased overall for the postprotocol population. Although we anticipated the length of hospital stay and length of ICU stay to decrease after the introduction of the emergency EVAR protocol, 45 this finding may reflect increased instability and comorbidity of patients in the postprotocol period.…”

Section: Discussionmentioning

confidence: 99%

Impact of an emergency endovascular aneurysm repair protocol on 30-day ruptured abdominal aortic aneurysm mortality

Jones¹,

Koury²,

Faris³

et al. 2022

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Impact of an emergency endovascular aneurysm repair protocol on 30-day ruptured abdominal aortic aneurysm mortality

Jones¹,

Koury²,

Faris³

et al. 2022

Journal of Vascular Surgery

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“… 7 Additionally, the introduction of EVAR has changed the management of RAAA dramatically and EVAR is considered the first-line treatment of RAAA in many institutions. 8 - 11 Thus, unavailability of EVAR at low-volume and non-tertiary hospitals may further centralize RAAA patients to teaching and tertiary level institutions and the influence of transfer should be considered in these circumstances as well.…”

Section: Discussionmentioning

confidence: 99%

In-hospital outcomes of ruptured abdominal aortic aneurysms: A single center experience

Tadayon

Mozafar

Zarrintan

2022

J Cardiovasc Thorac Res

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Introduction: Ruptured abdominal aortic aneurysm (RAAA) is a catastrophic condition with in-hospital mortalities up to 89%. Patient survival depends on multiple factors; however, prompt surgery is essential to prevent mortality. We report the in-hospital outcomes of RAAA at a high-volume and teaching vascular surgery center in Iran. Methods: This study is a single-center retrospective analysis of patients with infrarenal RAAA during February 20, 2012 to December 21, 2019 at Shohada-Tajrish Medical Center, Tehran,Iran. We identified 66 patients with RAAA during the study period. The patients were dividedinto two groups based on their transfer status (Transfer group versus non-transfer group). The primary outcome was in-hospital death. The secondary outcomes were in-hospital myocardial infarction (MI), abdominal compartment syndrome (ACS) and postoperative renal dysfunction requiring dialysis. Results: The mean age of the patients was 74.2 ± 8.3 years. Forty-seven patients (71.2%) were transferred to our center from other institutions. There were 46 in-hospital deaths (69.7%) and three in-hospital MIs (4.5%). Three patients (4.5%) had postoperative ACS and six patients (9.1%)had postoperative renal dysfunction requiring dialysis. Transfer patients had an increased rate of in-hospital death compared to non-transferred patients (76.6.1% versus 52.6%); however, the difference was not statistically significant (P=0.055). Conclusion: We found no significant different between operative mortality of transferred and non-transferred RAAA patients. Transfer of patients to tertiary centers with experienced vascular surgeons may delay the surgery. However, the transfer may be inevitable in areas where the optimal care of RAAA patients is not possible.

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“…A study reporting on patients requiring OAT after both open and endovascular repair of rAAA reported that 19% of them required OAT [36], with OAT more frequent after open surgery compared with endovascular repair. OAT was associated with prolonged surgery and higher fluid requirements intraoperatively; length of stay and perioperative mortality were also higher.…”

Section: Conditions Commonly Associated With Intra-abdominal Hyperten...mentioning

confidence: 99%

Intra-abdominal hypertension and abdominal compartment syndrome

Waele

2022

Current Opinion in Critical Care

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Purpose of reviewIntra-abdominal hypertension (IAH) has been acknowledged as an important contributor to organ dysfunction in critically ill patients, both in surgical and medical conditions. As our understanding of the pathophysiology evolves, risk factors are better recognized, preventive measures can now be implemented and therapeutic interventions tailored to the physiology of the patient. In the current review, we want to highlight developing insights in the epidemiology and treatment of patients with IAH and ACS. Recent findingsThe impact of IAH and ACS on kidney function and other outcomes continues to draw attention in recent studies. New methods for IAP measurement are under development, and the search for biomarkers to detect IAH or ACS continues. In conditions wherein IAH and ACS are common, recent studies allow better prevention and treatment of these conditions, based on the contemporary ICU management consisting of IAP measurement, judicious fluid resuscitation and decompressive laparotomy where necessary. Surgical treatment options including open abdomen therapy continue to be improved with demonstrable impact on outcomes.

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Comparative outcomes of open abdominal therapy after ruptured abdominal aortic aneurysm via open and endovascular approaches

Cited by 5 publications

References 16 publications

Impact of an emergency endovascular aneurysm repair protocol on 30-day ruptured abdominal aortic aneurysm mortality

Impact of an emergency endovascular aneurysm repair protocol on 30-day ruptured abdominal aortic aneurysm mortality

In-hospital outcomes of ruptured abdominal aortic aneurysms: A single center experience

Intra-abdominal hypertension and abdominal compartment syndrome

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