Colonic ischemia complicating open vs endovascular abdominal aortic aneurysm repair

Abstract

CI is significantly more common after open AAA repair and is associated with increased morbidity and a two- to fourfold increase in mortality.

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] . This disease severity score is a proprietary measure developed by Medstat (Ann Arbor, Michigan, USA) and is based on hospital admissions and discharges in the USA.…”

“…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.…”

“…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.…”

Right-Side Colon Ischemia: Clinical Features, Large Visceral Artery Occlusion, and Long-Term Follow-Up

“…ABES = angioplasty and balloon-expandable stent placement; CA = celiac artery; COPD = chronic obstructive pulmonary disease; IMA = inferior mesenteric artery; LSCI = left-side colon ischemia; RSCI = right-side colon ischemia; SMA = superior mesenteric artery. 2 A pathogenic role of large artery hypoperfusion is manifested when colon ischemia occurs after the IMA is sacrificed during surgery for abdominal aortic aneurysm 19,20 or colon resection, 21 as in case 4 (Table 2), eliminating a critical source of collateral supply to the distribution of a diseased SMA. Therapy of visceral artery occlusion is effective.…”

Microdialysis Monitoring of Biomarkers for Early Recognition of Intestinal Ischemia

“…The most common abdominal aneurysm occurs in the aorta, hence the term abdominal aortic aneurysm (AAA). Ischemic colitis is the most common complication after abdominal aortic aneurysm surgery (38,39) presenting a high impact in mortality rates (40)(41)(42)(43). Another high risk postoperative complication is the leakage of a low rectal anastomosis connection, or the site where the two transacted bowel segments are joined again, closing the bowel lumen (44).…”