The Impact of Reinterventions on Survival After Fenestrated and Branched Endovascular Aneurysm Repair

The type of anesthesia used during aneurysm repair affects postoperative outcomes for the patient. Although endovascular aneurysm repair (EVAR) appears to improve surgical outcomes, by convention, general anesthesia remains predominantly used. The aim of this study was to compare the impact of the type of anesthesia (ie, locoregional versus general anesthesia) on the outcomes following EVAR. A literature search was carried out using the PubMed search engine to find relevant published articles that compared locoregional and general anesthesia in patients undergoing EVAR. The review of the selected studies showed that although patients in the locoregional group were less medically fit compared with those in the general anesthesia group, there was a reduction in the cardiovascular support required during and after the surgery, postoperative hospital stay, intensive care unit (ICU) stay, and postoperative mortality and morbidity. Although there is no level 1 evidence for or against locoregional anesthesia in EVAR, conventionally, EVAR has been performed under general anesthesia. But this is rooted in tradition rather than evidence. This review suggests that locoregional anesthesia can improve postoperative outcomes following EVAR by reducing hospital stay, ICU stay, mortality, and morbidity, although other factors may also have some influence.

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PC038 The Impact of Contrast Media Volume Used During Endovascular Aneurysm Repair on Short- and Long-Term Renal Function

Journal of Vascular Surgery ◽

10.1016/j.jvs.2017.03.283 ◽

2017 ◽

Vol 65 (6) ◽

pp. 149S

Author(s):

Jennifer C. Grom ◽

Rami O. Tadros ◽

Melissa Baldwin ◽

Martin Kang ◽

Daniel K. Han ◽

...

Keyword(s):

Renal Function ◽

Contrast Media ◽

Endovascular Aneurysm Repair ◽

Short And Long Term ◽

Aneurysm Repair ◽

The Impact ◽

Media Volume

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The Impact of Endovascular Aneurysm Repair on Long-term Renal Function

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2018.08.022 ◽

2018 ◽

Vol 56 (6) ◽

pp. e29

Author(s):

Edmund R. Charles ◽

Dennis Lui ◽

Jonathan Delf ◽

Robert D. Sayers ◽

Matthew J. Bown ◽

...

Keyword(s):

Renal Function ◽

Endovascular Aneurysm Repair ◽

Aneurysm Repair ◽

The Impact

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The impact of obesity on perioperative and postoperative outcomes after elective endovascular abdominal aortic aneurysm repair

Vascular ◽

10.1177/17085381211063316 ◽

2021 ◽

pp. 170853812110633

Author(s):

Selami Gurkan ◽

Ozcan Gur ◽

Ayhan Sahin ◽

Mehmet Donbaloglu

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Endovascular Aneurysm Repair ◽

Group Versus ◽

Obese Group ◽

Obese Patients ◽

Dose Area Product ◽

Aneurysm Repair ◽

The Impact

Background Obesity is a common and growing health problem in vascular surgery patients, as it is in all patient groups. Evidence regarding body mass index (BMI) on endovascular aneurysm repair (EVAR) outcomes is not clear in the literature. We aimed to determine the impact of obesity on perioperative and midterm outcomes of elective EVAR between obese and non-obese patients. Methods Under a retrospective study design, a total of 120 patients (109 males, 11 females, mean age: 74.45 ± 8.59 (53–92 years)) undergoing elective EVAR between June 2012 and May 2020 were reviewed. Patients were stratified into two groups: obese (defined as a body mass index (BMI) ≥ 30 kg/m2) and non-obese (mean BMI < 30 kg/m2 (32.25 ± 1.07 kg/m2 vs 25.85 ± 2.69 kg/m2)). Results Of the 120 patients included in the study, 81 (67.5%) were defined as “nonobese,” while 39 (32.5%) were obese. The mean BMI of the study group was 27.93 ± 3.78 kg/m2. In obese patients, the procedure time, fluoroscopy time, and dose area product (DAP) values were longer than those of non-obese patients: 89.74 ± 20.54 vs 79.69 ± 28.77 min ( p = 0.035), 33.23 ± 10.14 vs 38.17 ± 8.61 min ( p = 0.01) and 133.69 ± 58.17 vs 232.56 ± 51.87 Gy.cm2 ( p < 0.001). Although there was no difference in sac shrinkage at 12-month follow-up, there was a significant decrease at 6-month follow-up in both groups ( p = 0.017). Endoleak occurred in 17.9% ( n = 7) of the obese group versus 11.1% ( n = 9) of the non-obese group ( p = 0.302). Iliac branch occlusion developed in four patients, 3 (3.7%) in the non-obese group and 1 (2.6%) in the obese group ( p = 0.608). The all-cause mortality rate was slightly higher in the obese group; however, it did not differ between the groups ( p = 0.463). Conclusion In addition to the longer procedure times, fluoroscopy times, and DAP values in obese patients, regardless of obesity, significant sac shrinkage in the first 6 months of follow-up was observed in both groups. No difference was documented with regards to mortality or morbidity following EVAR.

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