No abstract

Ex vivo repair technique for a complex renal artery aneurysm may have several advantages. Smaller incision size and use of minimally invasive techniques may decrease incisional morbidity and improve recovery time, especially in patients with a high body mass index. Improved visualization afforded by back-table methods may also be valuable when repair of aneurysms involving multiple branches is necessary. We report of a successful case of laparoscopic nephrectomy, followed by back-table aneurysmorrhaphy and autotransplant, in a patient with a renal artery aneurysm.

Ambulatory Services Databases. A multivariate analysis was completed to evaluate the impact of demographics, patient factors, type of symptoms (TIA or CVA), volume of cases, and interventions upon outcomes, including perioperative complications, length of stay, inpatient mortality, and cost. Significant factors were then used as part of a multivariate regression analysis to determine odds ratios.Results: As expected, symptomatic carotid artery disease generally portends a worse outlook after either CEA or CAS. COPD, PAD, and female gender are also predictors of postoperative CVA after CEA and CAS. CHF and PAD are predictors of postoperative MI after either intervention, and CHF, COPD, and PAD are all predictors of postoperative bleeding. The strongest predictors of inpatient mortality include symptomatic disease, CHF, diabetes, and female gender. Surprisingly, female gender was one of the strongest overall predictors of adverse outcome after CAS (OR 21.39 for death; P < .001). Low volume (<3 cases per year per practitioner) is a predictor of adverse outcome after CAS only (Table ).Conclusions: Higher rates of postoperative stroke and inpatient mortality for women undergoing CAS is an unexpected finding and may indicate that this population is vulnerable to complications after endovascular management. Low volume is a predictor of complications and subsequent mortality primarily for CAS.