AAA 26. Myocardial Injury After Noncardiac Surgery in Endovascular Aneurysm Repair Patients —Implications for Long-term All-Cause Mortality

Myocardial injury after noncardiac surgery (MINS) is prognostically relevant myocardial injury due to ischemia that occurs during or within 30  days after noncardiac surgery and is known to be independently associated with 30-day mortality after intervention. Nonetheless, the long-term prognostic importance of MINS in vascular surgery patients is poorly described, and the prevalence of MINS in endovascular aneurysm repair (EVAR) patients is unknown. Also, most studies use fourth-generation troponin T, which can have significant baseline increases in chronic kidney disease patients.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research

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AbstractPurposeTo evaluate the incidence of acute renal failure and chronic kidney disease due to occlusion of accessory renal arteries during endovascular aneurysm repair of infrarenal abdominal aortic aneurysm.Material and MethodsWe retrospectively reviewed the course of 181 patients (mean age, 71, SD  ± 9  years) who underwent EVAR of infrarenal abdominal aortic aneurysm. The renal vessel anatomy was analyzed in all pre- and postoperative CT scans. Diameter and origin of accessory renal arteries were evaluated. Renal function was determined by pre- and postoperative serum creatinine and ...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
Abstract INTRODUCTION: Over the short term endovascular aneurysm repair (EVAR) is associated with superior outcomes compared with open repair; however, the progression of renal function after EVAR remains unknown because of the use of inconsistent reporting measures. The aim was to define long term renal decline following elective EVAR using estimated glomerular filtration rate (eGFR). METHODS: The prospectively maintained in house database was used to identify consecutive patients having elective EVAR who had been followed up for more than five years. Overall, 275 patients (23 females, 8%; mean age, 75 years...
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
Dr Thomas S. Huber (Gainesville, Fla). The authors have analyzed the impact of preoperative anemia on the perioperative outcomes of both open and endovascular repair for intact aneurysms using the Vascular Quality Initiative. They have reported that anemia is associated with increased 30-day mortality and adverse outcome for endovascular but not open repair in their multivariate analysis. They reported that the adverse outcomes associated with anemia were independent of chronic kidney disease and congestive heart failure.
Source: Journal of Vascular Surgery - Category: Surgery Source Type: research
To compare outcomes in patients with normal, moderate and severe chronic kidney disease undergoing endovascular abdominal aortic aneurysm repair (EVAR) using devices with and without suprarenal fixation.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Abstracts Presented to the Vascular and Endovascular Surgery Society - 2019 Annual Winter Meeting Source Type: research
s N Abstract AIM: To compare early outcome after complex endovascular aortic repair in octogenarians (age ≥ 80 years) versus non-octogenarians (age 
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
Authors: Marques De Marino P, Martinez Lopez I, Cernuda Artero I, Cabrero Fernandez M, Pla Sanchez F, Ucles Cabeza O, Serrano Hernando FJ Abstract BACKGROUND: The aim of this study is to analyse renal function impairment (RFI) after abdominalaortic aneurysm (AAA) repair in patients with preoperative chronic kidney disease (CKD). METHODS: Retrospective cohort study of patients with CKD undergoing elective AAA repair between 2008-2015, dividing the sample into two groups: open repair (OR) and endovascular repair (EVAR). The primary outcome was RFI defined by the RIFLE scale, studying Risk (1.5-fold increase in Cr...
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
CONCLUSIONS: The introduction of a CEUS based protocol for EVAR follow up was safe and effective and it was similar to the previous CTA based follow up protocol with regard to identification of endoleaks in a mid-term period. Moreover, CEUS allowed for 90% reduction of CTA, thereby decreasing radiation exposure for patients. PMID: 29673811 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
AbstractPurposeAcute kidney injury (AKI) is a severe complication after infrarenal abdominal aortic aneurysm (iAAA) repair. Little data are available whether endovascular aneurysm (EVAR) or open aortic repair (OAR) differs with respect to AKI frequency and severity, consecutive development of chronic kidney disease (CKD) and potentially preventable and modifiable risk factors of AKI.Patients and methodsWe assessed AKI rates, AKI stages and CKD applying current, complete definitions from the kidney disease improving global outcomes initiative in propensity-score-matched cohorts of all patients with elective and urgent iAAA ...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
AbstractTo assess feasibility, efficacy and safety of carbon dioxide (CO2) digital subtraction angiography (DSA) to guide endovascular aneurysm repair (EVAR) in a cohort of patients with chronic kidney disease (CKD). After Ethical Committee approval, the records of 13 patients (all male, mean age 74.6  ± 8.0 years) with CKD, who underwent EVAR to exclude an abdominal aortic aneurysm (AAA) under CO2 angiography guidance, were reviewed. The AAA to be excluded had a mean diameter of 52.0  ± 8.0 mm. CO2 angiography was performed by automatic (n  = 7) or hand (n&thins...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
In this issue Dr van Eps and colleagues report on prognostic factors of acute kidney injury (AKI) and renal function decline leading to chronic kidney disease (CKD) following elective endovascular repair (EVAR) in a cohort of 212 consecutive patients with abdominal aortic aneurysm (AAA).1 Administration of an iodinated contrast agent to perform angiography during EVAR and computed tomographic angiography during follow-up to supervise the procedure and detect complications of EVAR are considered to be the main culprits in the development of AKI and subsequently CKD, observed in 15% and 23.5% of patients, respectively, in the authors' study.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Invited Commentary Source Type: research
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