Consumptive Coagulopathy Following Endovascular Stent Repair of Abdominal Aortic Aneurysm

Cross, K.S.; Bouchier-Hayes, D.; Leahy, A.

doi:10.1053/ejvs.1999.0970

Cited by 44 publications

(46 citation statements)

References 5 publications

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“…Although none of the patients in this study had any perioperative major complications, several studies reported that a serious inflammatory response might result in an extensive endothelial injury, owing to the direct effects of the mediating agents and the WBC-endothelial interaction. This can lead to an increased risk of postoperative morbidity, such as pulmonary dysfunction, cardiovascular events, renal insufficiency, and multisystem organ failure, particularly in high-risk patients [6,22,23,24]. In the future, studies of larger cohorts are warranted to identify risk factors for the development of a severe systemic inflammatory response, as well as to identify strategies that can control the inflammatory process after the elective repair of AAAs.…”

Section: Discussionmentioning

confidence: 99%

Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm

Baek

Kwon

et al. 2015

Ann Surg Treat Res

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PurposeThe present study aimed to evaluate the risk factors and the role of graft material in the development of an acute phase systemic inflammatory response, and the clinical outcome in patients who undergo endovascular aneurysm repair (EVAR) or open surgical repair (OSR) of an abdominal aortic aneurysm (AAA).MethodsWe retrospectively evaluated the risk factors and the role of graft material in an increased risk of developing systemic inflammatory response syndrome (SIRS), and the clinical outcome in patients who underwent EVAR or OSR of an AAA.ResultsA total of 308 consecutive patients who underwent AAA repair were included; 178 received EVAR and 130 received OSR. There was no significant difference in the incidence of SIRS between EVAR patients and OSR patients. Regardless of treatment modality, SIRS was observed more frequently in patients treated with woven polyester grafts. Postoperative hospitalization was significantly prolonged in patients that experienced SIRS. In multivariate analyses, the initial white blood cell count (P = 0.001) and the use of woven polyester grafts (P = 0.005) were significantly associated with an increased risk of developing SIRS in patients who underwent EVAR. By contrast, the use of woven polyester grafts was the only factor associated with an increased risk of developing SIRS in patients who underwent OSR, although this was not statistically significant (P = 0.052).ConclusionThe current study shows that the graft composition plays a primordial role in the development of SIRS, and it leads to prolonged hospitalization in both EVAR and OSR patients.

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Section: Discussionmentioning

confidence: 99%

Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm

Baek

Kwon

et al. 2015

Ann Surg Treat Res

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“…25,26 It has been suggested that continued perfusion of a thrombus-filled aneurysm sac might predispose to an acute-onchronic consumptive coagulopathy. 27,28 The present study confirms that patients with asymptomatic AAA exhibit a prothrombotic diathesis characterized by excessive thrombin generation as shown by markedly elevated PF1 ϩ 2 and TAT prior to EVAR.…”

Section: Discussionmentioning

confidence: 99%

Changes in thrombin generation, fibrinolysis, platelet and endothelial cell activity, and inflammation following endovascular abdominal aortic aneurysm repair

Abdelhamid

Davies

Adam

et al. 2012

Journal of Vascular Surgery

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“…7,8 Our patient had a significant decrease in platelet levels and a corresponding increase in coagulation time and levels of FDPs to suggest the onset of DIC immediately after EVAR. The platelet count remained low, and FDP levels were consistently raised until successful aortic banding, after which they returned to normal limits just 2 weeks after the procedure (Fig 4).…”

Section: Discussionmentioning

confidence: 74%

Disseminated intravascular coagulation after endovascular aneurysm repair: Resolution after aortic banding

Patel

Bell

Hunt

et al. 2009

Journal of Vascular Surgery

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Disseminated intravascular coagulation (DIC) has been shown to affect 2% to 4% of patients with abdominal aortic aneurysms. In rare cases of DIC caused by aneurysms, operative repair has been curative. Endovascular aneurysm repair (EVAR) has been established as an effective treatment. We report a 73-year-old man in whom severe bleeding developed from groin incisions and cannulae sites immediately after EVAR. An intraoperative angiogram showed a type I endoleak, but the procedure had to be abandoned due to continued bleeding. Blood tests confirmed a diagnosis of disseminated intravascular coagulation that persisted chronically 3 months postoperatively. Attempts to repair the endoleak with stenting were unsuccessful, resulting in persistence of disseminated intravascular coagulation. This resolved after successful treatment of the endoleak with aortic banding.

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Consumptive Coagulopathy Following Endovascular Stent Repair of Abdominal Aortic Aneurysm

Cited by 44 publications

References 5 publications

Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm

Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm

Changes in thrombin generation, fibrinolysis, platelet and endothelial cell activity, and inflammation following endovascular abdominal aortic aneurysm repair

Disseminated intravascular coagulation after endovascular aneurysm repair: Resolution after aortic banding

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