Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: Factors influencing outcome among 527 recent cases

Dardik, Alan; Burleyson, Gregg P.; Bowman, Helen M.; Gordon, Toby A.; Williams, G. M.; Webb, Thomas H.; Perler, Bruce A.

doi:10.1016/s0741-5214(98)70126-0

Cited by 155 publications

(99 citation statements)

References 26 publications

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“…AAA causes 15,000 deaths per year in the United States, and its incidence does not decrease over time. [4][5][6][7][8][9] An intraluminal thrombus (ILT) is present in approximately 75% of all cases of AAA. 10 Recent studies suggest that the ILT is an active pathogenic factor for AAA.…”

Section: Introductionmentioning

confidence: 99%

Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

et al. 2008

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Purpose: To assess the most frequent deposition site of mural thrombi in infrarenal abdominal aorta aneurisms, as well as the route of the residual lumen. Methods: Assessment of CT scan images from 100 patients presenting asymptomatic abdominal aorta aneurism, and followed at HC-FMRP-USP. Results: In 53% of the cases the mural thrombus was deposited on the anterior wall; from these, in 22%, the residual lumen described a predominantly right sided route; in 22%, a left sided route; on the mid line in 5%; and crossing over the mid line in 1%. In 23%, the deposition of thrombi was concentric. In 11% it occured on the posterior wall; from these, in 5%, the route of the residual anterior lumen was predominantly right sided; in 5%, left sided; and crossed over the mid line in 1%. In 13% complex morfological deposition patterns were found. Conclusion: Mural thrombi formation was predominantly found on the anterior wall of the aneurismatic mass, with the route of the residual lumen projecting towards the posterior wall. Key-words:Abdominal Aorta Aneurisms. Thrombi and CT Scan. RESUMOObjetivos: Avaliar o local mais freqüente de deposição do trombo mural em aneurismas de aorta abdominal infrarenal, bem como o trajeto da luz residual. Métodos: Avaliação de tomografias de 100 pacientes do HC-FMRP-USP apresentando aneurisma de aorta abdominal assintomático. Resultados: O trombo mural se deposita na parede anterior em 53% dos casos, sendo que a luz residual posterior descreveu um trajeto predominantemente à direita em 22% dos casos, à esquerda em 22%, na linha mediana em 5% e cruzando da direita para a esquerda em 4%. 23% dos casos apresentaram deposição concêntrica do trombo e 11% apresentaram deposição na parede posterior, sendo o trajeto da luz residual anterior predominante a direita em 5% dos casos, a esquerda em 5% e cruzando a linha mediana em 1%. Padrões morfológicos complexos de deposição do trombo foram encontrados em 13% dos casos. Conclusão: A formação do trombo mural predominou na parede anterior da massa aneurismática, com o trajeto da luz residual se projetando para a parede posterior.Descritores: Aneurisma de Aorta Abdominal. Trombo e Tomografia Computadorizada por Raios X. Guimarães TAS et al 152

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Section: Introductionmentioning

confidence: 99%

Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

et al. 2008

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“…[193][194][195] Circulatory failure may cause the complications of multiple organ failure, respiratory failure, renal failure, and colonic ischemia. 196,197 peutic results have been obtained owing to arch replacement using improved adjuvant measures and the recent introduction of fibrin glue and stent-grafts.…”

Section: (3) Therapeutic Resultsmentioning

confidence: 99%

Guidelines for Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection (JCS 2011)

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“…[2][3][4] Although many attempts to evaluate the risk factors of mortality in patients with rAAA have been published, no systems or variables have proven to be reliable in the accurate prediction of mortality. Previous studies have reported that preoperative systolic blood pressure <90 mmHg, prolonged shock (e.g., >5 h), unconsciousness, and cardiac arrest are independent risk factors of mortality.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] However, the mortality of ruptured AAA (rAAA) remains high despite advances in diagnostic methods, techniques for repair including endovascular aneurysm repair (EVAR), and intensive care. 1 Previously, several factors such as age, female sex, prolonged collapsed vital phase, massive transfusion, or hemorrhage during surgery, were considered independent risk factors of mortality.…”

Section: Introductionmentioning

confidence: 99%

“…1 Previously, several factors such as age, female sex, prolonged collapsed vital phase, massive transfusion, or hemorrhage during surgery, were considered independent risk factors of mortality. [2][3][4][5][6][7][8][9][10][11] However, these results are still not definitive and some studies were published in the 1990s. Between 2006 and 2012, 57 patients received emergency surgical treatment for AAA.…”

Section: Introductionmentioning

confidence: 99%

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Recent risk factors for open surgical mortality in patients with ruptured abdominal aortic aneurysm

Uchida

Akita

et al. 2014

Acute Medicine & Surgery

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Aim:We examined recent relevant prognostic factors for the outcome of open surgical treatment of ruptured abdominal aortic aneurysm.Methods: Between 2006 and 2012, 35 patients received emergency open surgical treatment for ruptured abdominal aortic aneurysm at our institute. We reviewed ambulance activity logs and clinical records of 34 infrarenal ruptured abdominal aortic aneurysm patients retrospectively. Univariate and multivariate logistic regression analyses were carried out to identify risk factors for surgical outcomes.Results: Eight patients died during surgery or within a few hours following surgery completion. Through univariate analysis, body mass index, serum lactate level, arterial blood pH, base excess, platelet count, prothrombin time-international normalized ratio, activated partial thromboplastin time, type of ruptured aneurysm, response to i.v. fluid resuscitation within 2,000 mL in the initial therapy, and volume of blood loss during surgery were detected to be significant variants. Multivariate logistic regression analysis revealed the patients who were hemodynamically stabilized after primary volume loading had a 13.2 times higher possibility of survival. Body mass index, high serum lactate level, and volume of blood loss were also found to be independent risk factors of mortality. Conclusion:The risk factors of open surgical ruptured abdominal aortic aneurysm repair, body mass index, lactate level, volume of intraoperative blood loss, and response to initial 2,000 mL fluid resuscitation were correlated to survival.

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Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: Factors influencing outcome among 527 recent cases

Cited by 155 publications

References 26 publications

Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

Morphological aspects of mural thrombi deposition residual lumen route in infrarenal abdominal aorta aneurisms

Guidelines for Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection (JCS 2011)

Recent risk factors for open surgical mortality in patients with ruptured abdominal aortic aneurysm

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