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Suprarenal clamping is a safe method of aortic control when infrarenal clamping is not desirable.

Abstract：

:We evaluated the safety of suprarenal aortic clamping in patients with abdominal aortic aneurysm (AAA) treated by open aortic replacement by retrospectively reviewing all patients who underwent elective AAA replacement at a university hospital from 1993 until 2003. We reviewed 249 patient charts and divided them into three groups according to the clamp location during aortic replacement: group 1, infrarenal clamp group (n = 185); group 2, suprarenal clamp group (n = 52); and group 3, supraceliac clamp group (n = 12). Groups 1 and 2 were compared with respect to risk factors, intraoperative events, and postoperative events. Statistical analysis was done using Wilcoxon's rank-sum test, chi-squared test, and Fisher's exact test. Risk factors were comparable in groups 1 and 2 except for weight, which was higher in group 1. Intraoperative urine output, hypotensive episodes, and use of renal protective drugs were comparable in the two groups. Operation time, blood loss, and use of IV fluids were all significantly higher in group 2, while total aortic clamp time was higher in group 1. Postoperative events were comparable except for postoperative peak creatinine, intensive care unit length of stay, and postoperative length of stay, which were higher in group 2; however, discharge creatinine was comparable without a significant difference. Suprarenal clamping is a safe method of aortic control during open AAA replacement surgery. The selection of clamping site should be individualized according to the intraoperative anatomy. Supraceliac clamping is not necessarily the preferable method of aortic control when the infrarenal location is not suitable for clamping.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Sharp WJ,Bashir M,Word R,Nicholson R,Bunch C,Corson J,Kresowik T,Hoballah J

doi

10.1016/j.avsg.2008.02.006

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

534-40

issue

4

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(08)00076-9

journal_volume

22

pub_type

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