Suprarenal Clamping Is a Safe Method of Aortic Control when Infrarenal Clamping Is not Desirable

Sharp, William J.; Bashir, Mohammad; Word, Ronnie; Nicholson, Rachael; Bunch, Christopher T.; Corson, John D.; Kresowik, Timothy F.; Hoballah, Jamal J.

doi:10.1016/j.avsg.2008.02.006

Cited by 20 publications

(26 citation statements)

References 18 publications

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“…[2][3][4]10,15,51,56,59 One study reported mortality Ͻ90 days, 1 while in five studies, no definition for perioperative mortality was found. 8,9,52,53,55,58 In 20 studies, postoperative new onset of temporary or permanent hemodialysis was presented. The pooled estimate of the cumulative incidence of new onset dialysis was 3.3% (95% CI, 2.4%-4.5%; Fig 3).…”

Section: Resultsmentioning

confidence: 97%

“…3,57-59 Administration of mannitol was used most often, 7,52,55,56,59 sometimes in combination with furosemide 1,4 or dopamine. 3,6,51,54,58 Chiesa et al used fenoldopam mesylate and methylprednisolone instead of mannitol and dopamine in some cases. 51 Sasaki et al used continuous dopamine infusion during renal ischemia time.…”

Section: Resultsmentioning

confidence: 97%

“…1,3,4,6,7,10,50,52,53,55 In four studies, JAA were not specifically defined. 10,53,58,59 Meta analysis. Extracted data from the included studies is presented in Table II.…”

Section: Resultsmentioning

confidence: 99%

“…From 19 studies, specific data on mortality or new onset of dialysis after non-ruptured open JAA repair could not be retrieved and were excluded, [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] resulting in 21 articles to be included in the systematic review. [1][2][3][4][5][6][7][8][9][10]15,[50][51][52][53][54][55][56][57][58][59] The chance adjusted interreviewer agreement for study eligibility (kappa) was 0.77.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Juxtarenal aortic aneurysm repair

Jongkind

Yeung

Akkersdijk

et al. 2010

Journal of Vascular Surgery

176

144

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 97%

“…1,3,4,6,7,10,50,52,53,55 In four studies, JAA were not specifically defined. 10,53,58,59 Meta analysis. Extracted data from the included studies is presented in Table II.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Juxtarenal aortic aneurysm repair

Jongkind

Yeung

Akkersdijk

et al. 2010

Journal of Vascular Surgery

176

144

View full text Add to dashboard Cite

show abstract

“…Data are directly entered into a secure website and completeness and accuracy of entered data are ensured and validated in a series of prior publications. [18][19][20][21][22] The NSQIP database captures the above noted information for a variety of surgical procedures; therefore, the preoperative and outcomes data collected therein are not procedure or surgical speciality specific. Particulars of the clinical variables evaluated, 30-day outcomes analyzed and study definitions are publically available.…”

Section: Methodsmentioning

confidence: 99%

Comparable mortality with open repair of complex and infrarenal aortic aneurysm

Patel

Lancaster

Conrad

et al. 2011

Journal of Vascular Surgery

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In contemporary practice the migration of open repair to increasingly complex cases has been achieved with 30-day mortality essentially equivalent to open repair of infrarenal AAA. Patients who require VVR do sustain increased complications, in particular renal failure. These data also emphasize the importance of baseline renal insufficiency in clinical decision making. CAA and VVR are associated with increased morbidity in comparison to AAA repair; however, both procedures can be safely performed in patients without increased risk of operative mortality.

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Surgical Repair of Juxtarenal Abdominal Aortic Aneurysms and safety of Suprarenal Aortic Clamping

et al. 2020

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Background Juxtarenal abdominal aortic aneurysm (AAA) comprises 15–20% of all AAAs and often requires open surgical repair (OSR) due to anatomical limitations associated with endovascular aneurysm repair (EVAR), particularly in the case of hostile proximal necks. This study aimed to evaluate short‐ and long‐term outcomes of suprarenal clamping during OSR of juxtarenal AAAs and compare the outcomes of this technique with those of infrarenal clamping for AAAs. Methods Between January 1 2014, and December 31 2016, 289 consecutive patients aged ≥40 years underwent primary repair for infrarenal AAAs, including 141 OSRs and 148 EVARs. Of the 141 patients, 20 were excluded and totally, 121 patients were included. Results All patients had fusiform‐type AAAs and were divided into infrarenal (N = 98) or suprarenal (N=23) clamp groups. The mean follow‐up period was 51.4 months (95% CI: 48.6–54.2). Mean survival time was 51.4 months (95% CI: 48.6–54.2). Thirty‐day mortality was 0.8%, and there was no significant difference between two groups (P >. 999). Renal complication in infrarenal clamp group was 4.1% and suprarenal clamp group was 4.3% (P >. 999). Old age (HR: 1.084; 95% CI: 1.025–1.147; P=.005) and high ASA score (HR: 2.361; 95% CI: 1.225–4.553; P =. 010) were substantially associated with in‐hospital complications. Conclusions Although endovascular procedures for repairing juxtarenal AAAs, such as fenestrated EVAR, have been developed, surgical repair is the standard treatment for juxtarenal AAAs. Morbidity and mortality due to open surgery were not higher in the juxtarenal AAA group than in the infrarenal AAA group. Therefore, need for suprarenal clamp should not preclude OSR and also there is continued need for training in surgical exposure of juxtarenal AAA and OSR.

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Suprarenal Clamping Is a Safe Method of Aortic Control when Infrarenal Clamping Is not Desirable

Cited by 20 publications

References 18 publications

Juxtarenal aortic aneurysm repair

Juxtarenal aortic aneurysm repair

Comparable mortality with open repair of complex and infrarenal aortic aneurysm

Surgical Repair of Juxtarenal Abdominal Aortic Aneurysms and safety of Suprarenal Aortic Clamping

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