Critical Analysis of Outcome Determinants Affecting Repair of Intact Aneurysms Involving the Visceral Aorta

Back, Martin R.; Bandyk, Matthew; Bradner, Michael W.; Cuthbertson, David; Johnson, Brad; Shames, Murray L.; Bandyk, Dennis F.

doi:10.1007/s10016-005-6843-3

Cited by 84 publications

(59 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other studies have demonstrated a correlation of the duration of suprarenal aortic clamping with the risk of AKI and severity of renal injury. [10,18,19] However, we were not able to demonstrate this relationship. It is likely that for a mild AKI, such as a 25% SCr increase, the average aortic crossclamping duration of 30 minutes is more than enough to trigger a renal insult.…”

Section: E Macedo Et Alcontrasting

confidence: 62%

“…[2,4,5] Therefore, the definition of AKI has recently changed toward more sensitive criteria. [6,7] The surgical repair of aortic aneurysms (AA) is associated with a high incidence of renal dysfunction, [8][9][10] and older studies suggest that there is a close relationship between the development of severe forms of AKI and mortality. [11][12][13][14] Surgical trauma (e.g., bleeding, hypovolemia, inflammation), ischemia reperfusion to kidneys, and other viscera and limbs are potentially involved in the pathogenesis of AKI related to AA surgical repair.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Mild Acute Kidney Injury (AKI) on Outcome after Open Repair of Aortic Aneurysms

Macedo

Castro

et al. 2008

Renal Failure

View full text Add to dashboard Cite

Recently, mild AKI has been considered as a risk factor for mortality in different scenarios. We conducted a retrospective analysis of the risk factors for two distinct definitions of AKI after elective repair of aortic aneurysms. Logistic regression was carried out to identify independent risk factors for AKI (defined as Ն25% or Ն50% increase in baseline SCr within 48 h after surgery, AKI 25% and AKI 50%, respectively) and for mortality. Of 77 patients studied (mean age 68 ± 10, 83% male), 57% developed AKI 25% and 33.7% AKI 50%. There were no differences between AKI and control groups regarding comorbidities and diameter of aneurysms. However, AKI patients needed a supra-renal aortic cross-clamping more frequently and were more severely ill. Overall in-hospital mortality was 27.3%, which was markedly higher in those requiring a supra-renal aortic cross-clamping. The risk factors for AKI 25% were suprarenal aortic cross-clamping (odds ratio 5.51, 95% CI 1.05-36.12, p = 0.04) and duration of operation for AKI 25% (OR 6.67, 95% CI 2.23-19.9, p < 0.001). For AKI 50%, in addition to those factors, post-operative use of vasoactive drugs remained as an independent factor (OR 6.13, 95% CI 1.64-22.8, p = 0.005). The risk factors associated with mortality were need of supra-renal aortic cross-clamping (OR 9.6, 95% CI 1.37-67.88, p = 0.02), development of AKI 50% (OR 8.84, 95% CI 1.31-59.39, p = 0.02), baseline GFR lower than 49 mL/min (OR 17.07, 95% CI 2.00-145.23, p = 0.009), and serum glucose > 118 mg/dL in the post-operative period (OR 19.99, p = 0.006). An increase of at least 50% in baseline SCr is a common event after surgical repair of aortic aneurysms, particularly when a supra-renal aortic cross-clamping is needed. Along with baseline moderate chronic renal failure, AKI is an independent factor contributing to the high mortality found in this scenario.

show abstract

Section: E Macedo Et Alcontrasting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Impact of Mild Acute Kidney Injury (AKI) on Outcome after Open Repair of Aortic Aneurysms

Macedo

Castro

et al. 2008

Renal Failure

View full text Add to dashboard Cite

show abstract

“…As a result, the percentage of aneurysms of the perirenal region for open repair is growing [13,17]. This is mainly due to the [2,10,11]. Open repair for JRA requires the use of a vascular clamping above the level of the renal arteries; the graft anastomosis itself is constructed infrarenally.…”

Section: Discussionmentioning

confidence: 99%

Comparative early and midterm results of open juxtarenal and infrarenal aneurysm repair

Ockert

Schumacher

Böckler

et al. 2007

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…Temporary or permanent dialysis after surgery has been reported, and the perioperative rate of new-onset dialysis ranges from 3% to 13% in published series [9, 14,16,27]. Reimplantation of the renal arteries and the requisite ischemic period during visceral revascularization likely are the largest sources of morbidity; however, it has been clearly shown that preoperative renal dysfunction predicts not only mortality, but also worsening renal dysfunction in the perioperative period [29].…”

Section: Introductionmentioning

confidence: 98%

Endovascular Treatment of Thoracoabdominal Aneurysm

Mastracci

2010

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

show abstract

Critical Analysis of Outcome Determinants Affecting Repair of Intact Aneurysms Involving the Visceral Aorta

Cited by 84 publications

References 23 publications

Impact of Mild Acute Kidney Injury (AKI) on Outcome after Open Repair of Aortic Aneurysms

Impact of Mild Acute Kidney Injury (AKI) on Outcome after Open Repair of Aortic Aneurysms

Comparative early and midterm results of open juxtarenal and infrarenal aneurysm repair

Endovascular Treatment of Thoracoabdominal Aneurysm

Contact Info

Product

Resources

About