Systematic Review and Meta-Analysis of Preventative Strategies for Acute Kidney Injury in Patients Undergoing Elective Abdominal Aortic Aneurysm Repair
To assess the effect of various preventative interventions, such as remote ischemic preconditioning (RIPC), versus standard therapy or placebo for reducing the incidence of postoperative acute kidney injury (AKI) in patients undergoing elective abdominal aortic aneurysm (AAA) repair.
Increased use of endovascular repair for intact abdominal aortic aneurysms has fundamentally shifted the approach to ruptured aneurysms. Unfortunately, not all patients are anatomically suited for endovascular repair. It is hypothesized that, in the endovascular era, patients undergoing open repair are increasingly complex; with an unknown impact on post-operative morbidity and mortality.
Postimplantation syndrome (PIS) is a systemic inflammatory response occurring in an early phase after abdominal aortic aneurysm (AAA) endovascular repair (EVAR). The pathophysiology underlying PIS is not yet well understood. It is speculated that the type of the stent graft or the mural thrombus within the AAA may play a role in determing this inflammatory response. At present, there is no consensus about the influence of PIS on clinical outcomes during follow-up. The endovascular aneurysm sealing (EVAS) with the Nellix sac-anchoring endoprosthesis (Nellix Endovascular, Palo Alto, Calif) is a novel modality for AAA repair ...
Endovascular repair (EVAR) is the dominant treatment modality for abdominal aortic aneurysm (AAA). Periprocedural risks are low, and cardiovascular events are the principle determinants of long-term survival. Recently, the concept of endovascular aneurysm sealing (EVAS) has been introduced into clinical investigation. In previous cohort studies EVAS has been associated with a lower all-cause mortality than expected despite device issues. We used a propensity weighted approach to investigate whether EVAS was associated with lower all-cause mortality after aneurysm repair.
We report an unusual case of a 65-year-old male patient with horseshoe kidney, who underwent a successful open repair for abdominal aortic aneurysm. The accessory renal arteries were perfused with histidine-tryptophan-ketoglutarate (HTK) solution (Custodiol ®; Dr. Franz-Kohler Chemie GmbH, Bensheim, Germany) during the vascular reconstruction. There were no creatinine and eGFR modifications in the postoperative time. In the literature, only two cases of Custodiol solution for kidney protection during aortic surgery are reported.
We report a case of an infrarenal abdominal aortic aneurysm (AAA) with unrecognized primary aortoduodenal fistula (ADF), treated by endovascular aortic repair (EVAR). Endograft infection was diagnosed 12 months thereafter. The associated ADF was uncovered during open surgery, which included endograft extraction, in-situ aortic reconstruction with a cryopreserved homograft (CHG) and duodenal repair. The patient was urgently reoperated in early postoperative course, due to CHG rupture and subsequent hemorrhagic shock.
Endovascular aortic aneurysm repair (EVR) has a major financial impact on health care systems. We characterized reimbursement for index EVR hospitalizations among Medicare beneficiaries having surgery at Vascular Quality Initiative (VQI) centers.
PMID: 31589486 [PubMed - in process]
CONCLUSIONS: Prophylactic prosthetic wrapping of vascular anastomosis in patients with Behçet's AAA in resource-challenged settings, where the proximal anastomoses were all end-to- end with wrapping, is an affordable, simple, reliable, and feasible technique, and commonly associated with a lower incidence of anastomotic site false aneurysms and different complications related to the implanted graft, where endovascular procedures might not be applicable. Moreover, the proper preoperative medical preparation for controlling the activity of Behçet's disease, with the administration of immunosuppressive agents, f...
Abstract BACKGROUND: The aim of this study was to examine the value preoperative AT as predictor of postoperative survival in patients who underwent elective EVAR for repair of asymptomatic AAA. METHODS: Consecutive patients who underwent elective EVAR between 2008 and 2018 were analysed. Cardiopulmonary exercise testing was performed. Perioperative/30 day mortality was compared between patients who had AT ≥8 ml kg-1 min-1 and those with AT
Authors: Bonfill X, Quintana MJ, Bellmunt S, Suclupe S, Gómez E, Fernández de Valderrama I, Castejón B, Miralles M, Pérez E, Escudero JR, AAA Spanish study group Abstract BACKGROUND: To assess potential variability in the clinical characteristics and treatment of patients undergoing elective surgery for abdominal aortic aneurysm (AAA) across five hospitals in Spain. METHODS: Multicenter, retrospective cohort study of patients diagnosed with AAA and treated with open surgical repair (OSR) or endovascular aneurysm repair (EVAR). We evaluated clinical and demographic variables, includin...