Outcomes of open repair of postdissection abdominal aortic aneurysms
This study describes the outcomes of open repair of PDAAA.
ConclusionThe mesh plug repair is safe and useful for the treatment of inguinal hernia after FFB, for which preoperative CT is helpful for understanding precise anatomy which facilitates surgical planning.
We read with great interest the study by O'Donnell et al,1 which investigated the risk factors of postoperative renal dysfunction after open repair of abdominal aortic aneurysm (AAA) in a large retrospective cohort.
We thank Drs Yoon and Kim for their interest in our study and the higher risk for acute kidney injury (AKI) after open repair of juxtarenal abdominal aortic aneurysms in patients taking statins preoperatively. Our understanding of the interaction between statins and postoperative renal function is constantly evolving, as both observational and randomized trials have met with mixed results. Importantly, previous studies showed that initiating statins in the perioperative period was associated with higher rates of postoperative AKI, whereas long-term statin use was associated with lower risk of renal complications.
In a commendable study, Abdulameer et al1 report on mortality by ruptured aortic aneurysms (rAAs) in the United States between 1999 and 2016. The main criticism of this study is that the terms death rate and rupture rate are used interchangeably as being the same. Evidently, death rate is the appropriate term and does not include the patients surviving a rupture. Perhaps these two terms were similar during the earlier study period of open repair. However, their difference becomes greater in the study's recent years, when endovascular aneurysm repair for rupture is increasingly used with significantly lower mortality.
The three randomized trials comparing endovascular aneurysm repair (rEVAR) with open surgical repair (rOSR) of ruptured abdominal aortic aneurysm (rAAA) were poorly designed and heavily criticized. The short- and long-term survival advantages of rEVAR remain unclear. We sought to compare the two treatment modalities using a propensity-matched analysis in a real-world setting.
The objective of this study was to report the 5-year outcomes of the Food and Drug Administration investigational device exemption clinical trial of endovascular aneurysm repair (EVAR) with the Ovation (Endologix, Irvine, Calif) stent graft for elective treatment of abdominal aortic aneurysm (AAA).
This study evaluates 30-day mortality after endovascular aneurysm repair (EVAR) vs open repair for ruptured complex abdominal aortic aneurysms (AAAs), including juxtarenal, pararenal, and suprarenal AAAs and extent IV thoracoabdominal aortic aneurysms, in a real-world setting.
The use of endovascular aneurysm repair (EVAR) has changed the treatment algorithm for patients with ruptured abdominal aortic aneurysms (RAAAs). Whereas the overall incidence of RAAA is declining, the proportion of patients treated with EVAR in contemporary practice in the United States is unknown. Therefore, we described the change in incidence, treatment pattern, and outcomes of RAAA using the National Inpatient Sample database from 2004 to 2015.
Growing calls for guidelines advocating minimum annual case volumes for surgeon credentialing remain controversial. Specifically, the impact of surgeon experience on procedure outcomes, such as open aortic repair (OAR), remains poorly understood. Therefore, the purpose of this study was to explore the influence of surgeon experience on case selection and real-world outcomes after OAR.
Surgical volume has been used as a surrogate for quality. Previous studies (with patient data before 2008) have suggested minimum volume requirements for surgeons (9-13 open abdominal aortic aneurysm repairs [OAAARs] per year) to achieve acceptable results. Given concerns about the decreasing volume of OAAAR, we examined the impact of surgeon volume on mortality in the Vascular Quality Initiative (VQI) registry.