scholarly journals Elective Repair of Abdominal Aortic Aneurysm: The Evidence is in but the Jury May Still be out

2020 ◽  
Vol 59 (3) ◽  
pp. 398
Author(s):  
Rita Soares Ferreira ◽  
Janet T. Powell
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic ◽  
Elective Repair

Perioperative Outcomes for Abdominal Aortic Aneurysm Repair Based on Aneurysm Diameter

2020 ◽  
Vol 54 (4) ◽  
pp. 341-347
Author(s):  
Christopher Ramos ◽  
Amit Pujari ◽  
Ravi R. Rajani ◽  
Guillermo A. Escobar ◽  
Brian G. Rubin ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Aneurysm Repair ◽  
Perioperative Outcomes ◽  
Improvement Program ◽  
Asymptomatic Patients ◽  
Abdominal Aortic ◽  
Elective Repair ◽  
Aneurysm Repair ◽  
Aneurysm Diameter

Background: Guidelines from the Society for Vascular Surgery recommend elective repair in asymptomatic patients with an abdominal aortic aneurysm (AAA) only if their diameter is greater than or equal to 5.5 cm, yet smaller ones are routinely repaired. This study aims to evaluate perioperative outcomes based on aneurysm size at the time of repair. Methods: Male patients who underwent elective endovascular aneurysm repair (EVAR) or open abdominal aneurysm repair (OAAR) repair of an infrarenal AAA were abstracted from 2011 to 2015 Targeted National Surgical Quality Improvement Program (NSQIP) database. Patients with symptoms or with aneurysmal extension into the visceral or iliac vessels were excluded. Outcomes of open versus endovascular repair were reported, with multivariate analyses to identify factors associated with the decision to repair AAA ≤5.4 cm. Results: A total of 2115 (90.9%) patients underwent EVAR, while 213 (9.1%) underwent OAAR. The mean diameter in patients who underwent OAAR was 6.1 cm (interquartile range [IQR]: 5.2-6.1 cm) versus 5.7 cm (IQR: 5.2-6.0 cm) for EVAR. However, in 42.5% of EVAR and 32.8% of OAAR patients, the diameter of the AAA was 5.4 cm or less. The group undergoing repair of AAA ≤5.4 cm was younger compared to the larger AAA group (71.9 vs 73.9 years; P < .0001). Patients older than 80 years were less likely to have a repair of AAA measuring ≤5.4 cm (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.30-0.65). Additionally, patients who underwent EVAR were more likely to have AAA measuring ≤5.4 cm repaired compared to those who underwent OAAR (OR = 1.62, 95% CI = 1.19-2.21). There were no differences in perioperative morbidity or mortality between the groups. Conclusion: There were no differences in perioperative outcomes after AAA repair, independent of aneurysm diameter. We found a higher likelihood of repairing AAA ≤5.4 cm in younger patients who were more likely to have been repaired with EVAR. Patients older than 80 years were less likely to undergo small AAA repair.

scholarly journals Preventing Rupture of Abdominal Aortic Aneurysm by Earlier Elective Repair

1994 ◽  
Vol 7 (4) ◽  
pp. 11-13 ◽  
Author(s):  
Robert C. Allen ◽  
C. M. Talkington ◽  
Wilson V. Garrett ◽  
Bertram L. Smith ◽  
Gregory J. Pearl ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic ◽  
Elective Repair

Predictors of mortality after emergency or elective repair of abdominal aortic aneurysm in a Japanese population

2012 ◽  
Vol 29 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Atsuko Nakayama ◽  
Hiroyuki Morita ◽  
Tetsuro Miyata ◽  
Katsuyuki Hoshina ◽  
Masatoshi Nagayama ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Japanese Population ◽  
Predictors Of Mortality ◽  
Abdominal Aortic ◽  
Elective Repair

Microalbuminuria and deterioration of renal function after elective repair of infrarenal abdominal aortic aneurysm

2006 ◽  
Vol 65 (03) ◽  
pp. 165-172 ◽  
Author(s):  
S. Nakamura ◽  
F. Yoshihara ◽  
K. Kamide ◽  
H. Nakahama ◽  
K. Nishigami ◽  
...  
Keyword(s):  
Renal Function ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Infrarenal Abdominal Aortic Aneurysm ◽  
Abdominal Aortic ◽  
Elective Repair

Elective endovascular vs. open repair for abdominal aortic aneurysm in octogenarians

Vascular ◽  
2016 ◽  
Vol 24 (4) ◽  
pp. 348-354 ◽  
Author(s):  
Koichi Morisaki ◽  
Takuya Matsumoto ◽  
Yutaka Matsubara ◽  
Kentaro Inoue ◽  
Yukihiko Aoyagi ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Operative Mortality ◽  
Open Repair ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Elective Repair ◽  
Aneurysm Repair ◽  
Repair Group

Purpose The purpose of this study was to investigate the operative mortality and short-term and midterm outcomes of treatment of abdominal aortic aneurysm in Japanese patients over 80 years of age. Methods Between January 2007 and December 2011, 207 patients underwent elective repair of infrarenal abdominal aortic aneurysms. Comorbidities, operative morbidity and mortality, midterm outcomes were analyzed retrospectively. Results The average age (endovascular aneurysm repair, 84.4 ± 0.3; open, 82.8 ± 0.3, P < 0.01) and the percentage of hostile abdomen (endovascular aneurysm repair, 22.2%; open repair, 11.1%, P < 0.05) were higher in the endovascular aneurysm repair group. Percentage of outside IFU was higher in open repair (endovascular aneurysm repair, 38.5%; open repair, 63.3%, P < 0.01). The cardiac complication (endovascular aneurysm repair, 0%; open repair, 5.6%, P < 0.01) and length of postoperative hospital stay (endovascular aneurysm repair, 10.3 ± 0.8 days; open, 18.6 ± 1.6 days, P < 0.05) were significantly lower in the endovascular aneurysm repair group. There were no differences in operative mortality (endovascular aneurysm repair, 0%; open, 1.1%, P = 0.43) and the aneurysm-related death was not observed. The rate of secondary interventions (EVAR, 5.1%; open repair, 0%, P < 0.01) and midterm mortality rate were much higher in the endovascular aneurysm repair group. Conclusions Endovascular aneurysm repair is less invasive than open repair and useful for treating abdominal aortic aneurysm in octogenarians; however, open repair can be acceptable treatment in the inappropriate case treated by endovascular aneurysm repair.

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