Colon ischemia following abdominal aortic aneurysm repair in the era of endovascular abdominal aortic repair

Abstract

CI remains a serious complication following AAA repair. In the univariate analysis, EVAR was associated with a lower rate of colonic ischemia. However, the logistic regression analysis showed that only rupture, long duration of operation, and prior renal disease were independently associated with CI. Within the two treatment modalities, the mortality rate remained identical.

Risk factors for ischaemic colitis after surgery for abdominal aortic aneurysm: a systematic review and observational meta-analysis

“…Female gender was associated with increased incidence of IC in two studies [9,10] . The natural logarithm of a disease severity score was recognised as positively associated with development of ischaemic colitis (mean severity score in IC 1311 vs 389 in no-IC, p<0.001) [9] .…”

“…The reported rates of ischaemic colitis after elective surgery ranged from 0% to 4.6% [11,12] versus 5% to 20.5% [13,14] after emergency surgery. Six studies looked in more depth at emergency presentations and found those who had ruptured aneurysm demonstrated a higher rate of IC compared to those who had not ruptured (3.2 to 6.4 times more likely in ruptures) [9,13,15,10,16,17] . The studies reporting this are retrospective cohort studies.…”

“…Pre-operative renal impairment was identified as a significant risk factor for development of ischaemic colitis in two papers, with reported odds ratios of 2.30 [14] and 4.67 [10] .…”

“…2.06 to 15.9) [10] . Neary et al investigated this relationship in their cohort and found a non-significant association between operative duration and incidence of post-repair IC, OR 0.95(0.84 to 1.09) [13] .…”

“…Eight studies of appropriate quality showed emergency surgery was associated with a relative risk of 7.36 (95% C.I. 3.08 to 17.58, p<0.001) (figure 2) [10,14,12,37,25,35,13,9] . In this analysis there was a high level of statistical heterogeneity.…”