IP071. Three Anatomic Severity Grading Score Subcomponents Create a Modified Score That Can Predict Patients at Increased Risk for Type Ia Endoleak Formation During Endovascular Abdominal Aneurysm Repair

Abstract

Program targeted AAA database from 2012 to 2014 to identify patients undergoing open AAA repair. The patients with missing information about the intraoperative management and chronically occluded IMA were excluded. Variables, including patient and aneurysm characteristics, operative techniques, and postoperative complications, were selected for univariate analysis. Variables with an association of P < .2 were then tested using multiple logistic regression analysis. Results: Of 1901 patients undergoing open AAA repair from 2012 to 2014, the incidence of ischemic colitis in the emergency cohort was 8.4% (43 of 513) and the elective cohort was 4% (55 of 1388). A total of 770 patients had a confirmed patent IMA and met the study criteria. The mean age was 69.88 6 9.3 years (Table I). The IMA was replanted in 82 patients (10.6%) and ligated in 688 patients (89.4%) intraoperatively. Ischemic colitis developed in eight patients (9.8%) with a replanted IMA and in 38 patients (5.5%) with a ligated IMA. The 30-day mortality was 12 of 82 (14.6%) in the IMA implanted cohort compared with 52 of 688 (7.6%) in the IMA ligated cohort (P ¼ .028). After controlling for preoperative factors and operative technique, ligating vs replanting IMA was not significantly associated with ischemic colitis (Table II). However, in multivariate analysis, ischemic colitis (OR, 4.683; CI, 2.10-10.4; P < .001), emergency surgery (OR, 6.109; CI, 3.41-10.91; P < .001), age (OR, 1.103; CI, 1.06-1.14; P < .001), and operative time (OR, 1.002; CI, 1.00-1.06; P ¼ .031) were independently associated with 30-day mortality (Table II). Conclusions: The IMA replantation during open AAA repair does not prevent or decrease an incidence of colon ischemia, whereas, this procedure increases operative time significantly, which is independently associated with 30-day mortality.