No abstract

Acute and chronic renal dysfunction both occur in approximately one-quarter of patients after fEVAR; however, most of these cases are classified as mild according to consensus definitions of renal injury. The presence of mild or moderate baseline kidney disease should not preclude endovascular repair in the juxtarenal population. Routine biochemical analysis and branch vessel surveillance remain important aspects of clinical follow-up for patients undergoing fEVAR.

No abstract

Objectives: This study evaluated the impact of exposure technique on perioperative complications in patients undergoing elective open abdominal aortic aneurysm (AAA) repair.Methods: The Society for Vascular Surgery Vascular Quality Initiative (VQI) database was used to identify patients who underwent open AAA repair from January 2003 to July 2014. Patients were divided into two aortic exposure groups, retroperitoneal (RETRO) vs transperitoneal (TRANS). Multivariable analysis was performed to compare the incidence of cardiac events (myocardial infarction, dysrhythmia, heart failure), prolonged intubation, renal dysfunction, and mortality, adjusting for betweengroup differences identified on univariate analysis.Results: Open AAA repair was performed in 3530 patients, using RETRO in 26% and TRANS in 74%. The RETRO group had a higher rate of suprarenal aortic clamp (60.9% vs 30.2%, P < .001), a higher proportion of highrisk patients as stratified by the Vascular Study Group Cardiac Risk Index (25.6% vs 22.2%, P ¼ .038), and lower rate of iliac aneurysms (18.0% vs 31.2%, P < .001). After multivariable analysis, RETRO was associated with a lower incidence of cardiac events (12.2% vs 16.0%, adjusted odds ratio, 0.60; 95% confidence interval, 0.41-0.88; P ¼ .009) and renal dysfunction (13.3% vs 16.5%, adjusted odds ratio, 0.65; 95% confidence interval, 0.46-0.97; P ¼ .011). No difference in respiratory complications or mortality was identified.Conclusions: Despite increased utilization of suprarenal aortic clamp during elective open AAA repair, the RETRO technique was associated with a lower riskadjusted incidence of cardiac and renal complications compared with the TRANS technique.

No abstract