Risk-scoring methods in predicting the immediate outcome after emergency open repair of ruptured abdominal aortic aneurysm

E, Leo; Biancari, Fausto; Nesi, Fabrizio; Pogany, Gabriele; Bartolucci, R; Pasquale, Filippo De; Rainio, Pekka; Satta, Jari; Rabitti, G; Juvonen, Tatu

doi:10.1016/j.amjsurg.2006.01.026

Cited by 35 publications

(33 citation statements)

References 14 publications

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“…These results are in accordance with previous disappointing results on discrimination, 27 but in conflict with previous fairly accurate results on calibration. 23 Therefore, the accuracy of the Vancouver Figure 4.…”

Section: Vancouver Scoresupporting

confidence: 70%

Editor's Choice - External Validation of Models Predicting Survival After Ruptured Abdominal Aortic Aneurysm Repair

Beek

Reimerink

Vahl

et al. 2015

European Journal of Vascular and Endovascular Surgery

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Section: Vancouver Scoresupporting

confidence: 70%

Editor's Choice - External Validation of Models Predicting Survival After Ruptured Abdominal Aortic Aneurysm Repair

Beek

Reimerink

Vahl

et al. 2015

European Journal of Vascular and Endovascular Surgery

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“…We discuss the pertinent anaesthetic issues when a patient presents with a vascular emergency and the impact that endovascular repair has on anaesthetic management. In-hospital mortality after open repair of ruptured abdominal aortic aneurysm (rAAA) approaches 40-50% with total mortality, including pre-hospital deaths, closer to 80% [1][2][3]. Traumatic thoracic aortic injury is often immediately fatal with a 30-40% mortality in those who arrive alive to hospital and an overall mortality of 90% [4].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of renal failure after rTAAA repair is reported to be between 4% and 40% [5] and 16-26% following rAAA repair [3,85,86]. Prolonged clamp time, hypotension, decreased cardiac output, anaemia, high contrast load in endovascular techniques and preexisting renal impairment [86,87] are important risk factors.…”

Section: Renalmentioning

confidence: 99%

Anaesthesia for vascular emergencies

Ellard¹,

Djaiani

2012

Anaesthesia

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SummaryPatients presenting with vascular emergencies including acute aortic syndrome, ruptured thoracic or abdominal aortic aneurysms, thoracic aortic trauma and acute lower limb ischaemia have a high risk of peri-operative morbidity and mortality. Although anatomical suitability is not universal, endovascular surgery may improve mortality and the results of ongoing randomised controlled trials are awaited. Permissive hypotension pre-operatively should be the standard of care with the systolic blood pressure kept to 50-100 mmHg as long as consciousness is maintained. The benefit of local anaesthesia over general anaesthesia is not definitive and this decision should be tailored for a given patient and circumstance. Cerebrospinal fluid drainage for prevention of paraplegia is often impractical in the emergency setting and is not backed by strong evidence; however, it should be considered postoperatively if symptoms develop. We discuss the pertinent anaesthetic issues when a patient presents with a vascular emergency and the impact that endovascular repair has on anaesthetic management. In-hospital mortality after open repair of ruptured abdominal aortic aneurysm (rAAA) approaches 40-50% with total mortality, including pre-hospital deaths, closer to 80% [1][2][3]. Traumatic thoracic aortic injury is often immediately fatal with a 30-40% mortality in those who arrive alive to hospital and an overall mortality of 90% [4]. Thirty-day mortality rates are > 50% following ruptured thoracic aneurysm [5], 13% for acute type B dissection [6] and > 25% following embolectomy for acute limb ischaemia [7,8].We define a 'vascular emergency', for the purpose of this review, as an acute condition requiring intervention within hours, involving the descending aorta and its main lower limb branches. Specific pathologies meeting these criteria include acute aortic syndrome, ruptured thoracic and abdominal aneurysms, traumatic injuries of the thoracic aorta and acute lower limb ischaemia. Pathology involving the ascending aorta or aortic arch that is generally managed by cardiac surgeons is excluded.This review aims to discuss the optimal anaesthetic management to minimise morbidity and mortality and the impact of a move towards endovascular repair. An English language electronic search using Medline and Embase databases identified relevant scientific literature from the last 10 years and was supplemented with a manual search of reference lists from reviewed articles. Overview of vascular emergenciesAcute aortic syndrome Acute aortic syndrome consists of three interrelated conditions: penetrating atherosclerotic ulcer; intramural haematoma; and aortic dissection. Penetrating athero-

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“…[224][225][226]241,242 It is vital to recognize the S&S of dissecting AAA as this is a surgical emergency.…”

Section: Emergency Referral Without Imaging [Gpp]mentioning

confidence: 99%

Diagnostic Imaging Practice Guidelines for Musculoskeletal Complaints in Adults—An Evidence-Based Approach—Part 3: Spinal Disorders

Bussières¹,

Taylor²,

Peterson³

2008

Journal of Manipulative and Physiological Therapeutics

114

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Risk-scoring methods in predicting the immediate outcome after emergency open repair of ruptured abdominal aortic aneurysm

Cited by 35 publications

References 14 publications

Editor's Choice - External Validation of Models Predicting Survival After Ruptured Abdominal Aortic Aneurysm Repair

Editor's Choice - External Validation of Models Predicting Survival After Ruptured Abdominal Aortic Aneurysm Repair

Anaesthesia for vascular emergencies

Diagnostic Imaging Practice Guidelines for Musculoskeletal Complaints in Adults—An Evidence-Based Approach—Part 3: Spinal Disorders

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