Innovations in Treating Aortic Diseases: The Abdominal Aorta

Subramaniam, Bala; Singh, Nina; Roscher, Christopher; Augoustides, John

doi:10.1053/j.jvca.2010.10.003

Cited by 7 publications

(3 citation statements)

References 61 publications

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“…Although improved outcomes have been described using restrictive fluid management, a recent Cochrane review concluded that there is little evidence at present to guide fluid therapy for this surgery and that further trials on this topic are required. 25,26 The influence of proximal clamp site on postoperative respiratory failure is debated: proportionally higher complication rates have been described depending on cranial aneurysmal extension. There may be a correlation between clamp site and increasing infusion volumes required to balance the hemodynamic consequences, although comparing studies is difficult given differences in clamp site selection.…”

Section: Discussionmentioning

confidence: 99%

Results after elective open repair of pararenal abdominal aortic aneurysms

Ferrante

Moscato

Colacchio

et al. 2016

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Results after elective open repair of pararenal abdominal aortic aneurysms

Ferrante

Moscato

Colacchio

et al. 2016

Journal of Vascular Surgery

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“…Selective angiography of the ITA requires a relatively long period of exposure time, and may result in infrequent complications, such as dissection or embolization with subsequent cerebrovascular ischemia [31]. However, selective ITA angiography can reveal significant proximal subclavian artery stenosis and, when it is performed, allows the visualization of intra-abdominal anastomoses in the presence of highly developed superior and inferior epigastric arteries and of large ITAs [43], which has been directly related to the severity of aortoiliac disease [37,44].…”

Section: Discussionmentioning

confidence: 99%

The use of both internal thoracic arteries for coronary revascularization increases the estimate of post-operative lower limb ischemia in patients with peripheral artery disease

Micali

Bonacchi

Weigel

et al. 2020

J Cardiothorac Surg

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Background Patients with a history of peripheral arterial disease (PAD) undergoing coronary artery bypass grafting (CABG) exhibit higher rates of complications. There are conflicting data on the survival benefits for bilateral thoracic artery (BITA) grafting compared with left internal thoracic artery (LITA) CABG in patients with PAD. The aim of the study was to explore the influence of the use of BITA grafts vs. LITA for CABG on post-operative acute lower limb ischemia (ALLI) and main post-operative complications in patients with concomitant PAD. Methods We used a propensity-score (PS) based analysis to compare outcomes between the two surgical procedures, BITA and LITA. The inverse probability of treatment weighting PS technique was applied to adjust for pre- and intra-operative confounders, and to get optimal balancing of the pre-operative data. The primary outcome was the estimate of postoperative ALLI. Secondary outcomes included overall death and death of cardiac causes within 30 days of surgery, stroke and acute kidney disease (AKD). Results The study population consisted of 1961 patients. The LITA procedure was performed in 1768 patients whereas 193 patients underwent a BITA technique. The estimate of ALLI was 14% higher in the BITA compared to the LITA (p < 0.001) group. Thirty-day mortality, cardiac death, occurrence of stroke and AKI did not differ significantly between the groups. Conclusions The use of both ITAs led to a significant increase in ALLI. This result was most likely caused by the complete disruption of the ITA collateral providing additional blood supply to the lower extremities. Based on our data, BITA should be used with extreme caution in PAD patients. Further research on this topic is necessary to confirm our findings.

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“…Although there are anatomic limitations of the available devices, these continue to lessen with increased use of branched and fenestrated grafts, which allow for the repair of the aneurysm involving the critical branch vessel. [9] Predictably, as shown by many innovations in surgical approaches, there is a pendulum effect. Open surgical repair is preferred for younger patients with low operative risk, and EVAR is preferred for older patients with higher operative risk.…”

Section: Discussionmentioning

confidence: 99%

Open surgical repair of abdominal aortic aneurysm: Proximal aortic control by endoaortic balloon - A novel approach

et al. 2012

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Patients with infrarenal abdominal aortic aneurysm with unfavorable anatomy for endovascular aneurysm repair have to undergo open surgical repair. Open surgery has its own morbidity in terms of proximal clamping and declamping, bleeding and prolonged hospital stay and mortality. We present two such patients with juxtarenal abdominal aortic aneurysm who underwent open surgical repair. The proximal aortic control during open surgical repair of the aneurysm was achieved by endoaortic balloon occlusion technique.

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Innovations in Treating Aortic Diseases: The Abdominal Aorta

Cited by 7 publications

References 61 publications

Results after elective open repair of pararenal abdominal aortic aneurysms

Results after elective open repair of pararenal abdominal aortic aneurysms

The use of both internal thoracic arteries for coronary revascularization increases the estimate of post-operative lower limb ischemia in patients with peripheral artery disease

Open surgical repair of abdominal aortic aneurysm: Proximal aortic control by endoaortic balloon - A novel approach

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